| Stephanie R. Wilder Pa-c | |
|
313 E Florida Ave Union City TN 38261-3957 | |
| (731) 599-0261 | |
| (986) 786-5149 |
| Full Name | Stephanie R. Wilder Pa-c |
|---|---|
| Speciality | Clinic/center |
| Location | 313 E Florida Ave, Union City, Tennessee |
| Authorized Official Name and Position | Danielle Keller (CERTIFIED PHYSICIAN ASSISTANT) |
| Authorized Official Contact | 7315990261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie R. Wilder Pa-c 313 E Florida Ave Union City TN 38261-3957 Ph: (731) 599-0261 | Stephanie R. Wilder Pa-c 313 E Florida Ave Union City TN 38261-3957 Ph: (731) 599-0261 |
| NPI Number | 1104303924 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 09/02/2025 |
| Certification Date | 05/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104303924 | NPI | - | NPPES |
| 1366098436 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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