| Jeremy Lee Wilt, NP | |
|
9431 County Road 403, Charlestown, IN 47111-8946 | |
| (812) 256-6391 | |
| Not Available |
| Full Name | Jeremy Lee Wilt |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 9431 County Road 403, Charlestown, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043689672 | NPI | - | NPPES |
| F0915751 | Other | IN | AANP CERTIFICATION |
| 28165750A | Other | IN | INDIANA LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 71005761A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 28165750A (Indiana) | Primary |
| Entity Name | First Urology Psc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922099811 PECOS PAC ID: 3779572888 Enrollment ID: O20040602000501 |
| Entity Name | Louisville Geriatric Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922337617 PECOS PAC ID: 1557380086 Enrollment ID: O20080821000664 |
| Entity Name | Wall Street Medical Group Inpatient Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992312862 PECOS PAC ID: 3274953526 Enrollment ID: O20201026002684 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy Lee Wilt, NP 9431 County Road 403, Charlestown, IN 47111-8946 Ph: (812) 256-6391 | Jeremy Lee Wilt, NP 9431 County Road 403, Charlestown, IN 47111-8946 Ph: (812) 256-6391 |
Stacey Mckenzie, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5445 Sky Ridge Rd, Charlestown, IN 47111 Phone: 812-246-3206 | |
Erica Lowry, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9501 County Road 403, Charlestown, IN 47111 Phone: 812-256-2338 | |
Brittany Ann Winsor, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9431 County Road 403, Charlestown, IN 47111 Phone: 502-256-6391 Fax: 812-256-9105 | |
Brittany Allman, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9501 County Road 403, Charlestown, IN 47111 Phone: 812-256-2338 Fax: 812-256-2497 | |
Kathleen W Free, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2300 Market St, Charlestown, IN 47111 Phone: 812-256-5506 | |
Kasey Garza, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9501 County Road 403, Charlestown, IN 47111 Phone: 812-256-2338 |