Alice L Wilson, LPN
Individual provider Active NPI Licensed Practical Nurse · Gray, LA
NPI 1891565636 · NPPES record last updated Jan 3, 2024
Key facts
- NPI
- 1891565636
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 20100410 (LA)
- Practice address
- 4266 W Main St Ste 101
Gray, LA 70359-6421 - Phone
- (985) 713-2747
- NPI assigned
- Jan 3, 2024
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 20100410 | LA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 20100410 | LA | Yes |
Addresses
Primary practice location
4266 W Main St Ste 101
Gray, LA 70359-6421
Mailing address
PO Box 1264
Gray, LA 70359-1264
Phone (985) 713-2747
Other names
- Alice L Dewey
Other providers in Gray, LA
- Ultrasound Enterprise LLC
- Sade Verdin
- Angela Chiasson Waddell
- McCall Richard Walker
- Natesha Rhodes Williams
- Marilyn P Wilson
- Mark W Wright
- Wsecrets Laboratory Services LLC
All providers in Gray, LA · Licensed Practical Nurse in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.