Virginia Daggett Wilder, PHD, MSN, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.304192 Issued in IL

Practice address

1481 W 10TH St
Indianapolis, IN 46202-2803

Phone

(317) 988-3155

NPI assigned

Jul 19, 2007

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 names 1

• Dr. Virginia Sue Daggett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Doctor of Philosophy, Registered Nurse

State licenses

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1619177557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 HERITAGE DR",
            "city": "MACKINAW",
            "state": "IL",
            "postal_code": "617558999",
            "telephone_number": "309-256-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "VIRGINIA",
        "middle_name": "DAGGETT",
        "name_prefix": "Dr.",
        "credential": "PHD, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.304192",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28191988A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "DAGGETT",
            "middle_name": "SUE",
            "prefix": "DR.",
            "credential": "PHD, MSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Michael Walter Wildman, N.D
• Sarah J. Wildman, PA

• Registered Nurse in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.