Wilt, Jeremy Lee

Wilt, Jeremy Lee is an sole proprietor health care provider with primary practice located at 9431 County Road 403 , Charlestown IN 47111-8946. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Wilt, Jeremy Lee can be contacted via phone (812) 256-6391.

Contact Information

Primary practice address
9431 County Road 403 Charlestown IN 47111-8946
Phone: (812) 256-6391
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71005761A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28165750A Indiana

Profile Details

NPI number 1043689672
LBN Legal business name Wilt, Jeremy Lee
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2015
Last updated Nov 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043689672 NPPES
Indiana Other F0915751 AANP CERTIFICATION
Indiana Other 28165750A AANP CERTIFICATION

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