Rachel Ann Wildman Dellos, DNP APRN-CNP NNP-BC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

24385 Issued in SC

Practice address

10 McClennan Banks Dr
Charleston, SC 29401-1164

Phone

(843) 985-1569

NPI assigned

Jan 24, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Rachel Ann Wildman-Dellos Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1215208111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MCCLENNAN BANKS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011164",
            "telephone_number": "843-985-1569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2951 Maple Ave.",
            "address_2": "c/o Women's & Children's Services, 2nd floor",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "43701",
            "country_code": "US",
            "telephone_number": "740-454-4095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2951 Maple Ave.",
            "address_2": "c/o Women's & Children's Services, 2nd floor",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "43701",
            "country_code": "US",
            "telephone_number": "740-454-4095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDMAN DELLOS",
        "first_name": "RACHEL",
        "middle_name": "ANN",
        "credential": "DNP APRN-CNP NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OH",
            "license": "APRN.CNP.13049",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "SC",
            "license": "24385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO APRN LICENSE",
            "identifier": "APRN.CNP.13049",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFYING CORPORATION",
            "identifier": "104367549",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO RN LICENSE",
            "identifier": "RN.339992",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC APRN LICENSE",
            "identifier": "24385",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "WILDMAN-DELLOS",
            "middle_name": "ANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alexandra Griffin Wild, DDS
• David Chamberlayne Wilde Jr., MD
• Fredreana Wilder
• Lashana Jonette Wilder, P.A.
• Lauren Elizabeth Wilder, MD
• Jenna Kaye Wildman, M.D.
• Robert Boyd Wildman
• Chloe Wilds, LPC-A
• Robert H Wilds, OD
• Suzanne Lynn Wilds, D.C.

• Critical Care Neonatal Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Critical Care Neonatal Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.