| Denise V Wilson, CRNP | |
|
957 National Hwy Ste 3, Lavale, MD 21502-7356 | |
| (240) 362-7128 | |
| (240) 362-7129 |
| Full Name | Denise V Wilson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 21 Years |
| Location | 957 National Hwy Ste 3, Lavale, Maryland |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255370524 | NPI | - | NPPES |
| 187329YDSJ | Other | MD | MEDICARE-UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | R137604 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Western Maryland Regional Medical Center | Cumberland, MD | Hospital |
| Potomac Valley Hospital | Keyser, WV | Hospital |
| West Virginia University Hospitals | Morgantown, WV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Proactive Pain And Neurology Llc | 1355609355 | 5 |
| Entity Name | Rosario Gonzaga Md Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356684302 PECOS PAC ID: 9032340419 Enrollment ID: O20140327002007 |
| Entity Name | Proactive Pain And Neurology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417460619 PECOS PAC ID: 1355609355 Enrollment ID: O20171221000314 |
| Mailing Address | Practice Location Address |
|---|---|
| Denise V Wilson, CRNP 957 National Highway, Ste 3, Lavale, MD 21502 Ph: (240) 362-7128 | Denise V Wilson, CRNP 957 National Hwy Ste 3, Lavale, MD 21502-7356 Ph: (240) 362-7128 |
Mrs. Corrine Lorraine Lamm, CRNP Registered Nurse Medicare: Medicare Enrolled Practice Location: 920 National Highway, Lavale, MD 21502 Phone: 301-759-4544 Fax: 301-723-4446 |