Provider Demographics
NPI:1053371120
Name:WILSON, BARBARA V (NP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:V
Last Name:WILSON
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:4755 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 1E-20
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-733-5625
Mailing Address - Fax:302-733-5665
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 1-E-20
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-234-5800
Practice Address - Fax:302-234-2380
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DELB-0000161363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000015398Medicaid
DE010523X32Medicare PIN
DE1000015398Medicaid