Cheyenne Jodene Wilson, LPN

Individual provider Active NPI Licensed Practical Nurse · Coshocton, OH

NPI 1689798795 · NPPES record last updated Dec 2, 2008

Key facts

NPI
1689798795
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN 131924 (OH)
Practice address
15452 County Road 274
Coshocton, OH 43812-8908
Phone
(740) 829-2329
Fax
(740) 829-2329
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN 131924OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 131924 OH Yes

Addresses

Primary practice location

15452 County Road 274
Coshocton, OH 43812-8908

Mailing address

15452 County Road 274
Coshocton, OH 43812-8908
Phone (740) 829-2329

Other providers in Coshocton, OH

All providers in Coshocton, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.