| Brandon Wilson, CNP | |
|
1320 W Main St, Newark, OH 43055-1822 | |
| (220) 564-4475 | |
| (220) 564-4412 |
| Full Name | Brandon Wilson |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 1320 W Main St, Newark, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689207292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 026226 (Ohio) | Secondary |
| 363L00000X | Nurse Practitioner | 026226 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Licking Memorial Hospital | Newark, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Licking Memorial Professional Corporation | 6204740731 | 200 |
| Entity Name | Licking Memorial Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326072265 PECOS PAC ID: 6204740731 Enrollment ID: O20031203000131 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon Wilson, CNP 1320 W Main St, Newark, OH 43055-1822 Ph: (220) 564-4475 | Brandon Wilson, CNP 1320 W Main St, Newark, OH 43055-1822 Ph: (220) 564-4475 |
Joan Crumrine, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Licking Memorial Family Practice East, 399 E. Main St, Newark, OH 43055 Phone: 220-564-1846 Fax: 220-564-1847 | |
Mrs. Sarah Elizabeth Karling, APRN, WHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 15 Messimer Dr, Newark, OH 43055 Phone: 220-564-4677 | |
Andrea Sims, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1320 W Main St, Newark, OH 43055 Phone: 220-564-4000 | |
Diane Elaine Kintner, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 675 Price Rd Ne, Newark, OH 43055 Phone: 740-349-6535 Fax: 740-349-6510 | |
Catherine R Wohlford, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 399 E Main St, Newark, OH 43055 Phone: 220-564-1840 Fax: 220-564-1841 | |
Robert Storm Speelman, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1320 W Main St, Newark, OH 43055 Phone: 220-564-4144 Fax: 220-564-7153 | |
Christopher Sobecki, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 65 Messimer Dr, Newark, OH 43055 Phone: 740-522-8477 |