Wilson, Hettie Tabitha
Wilson, Hettie Tabitha is an individual health care provider with primary practice located at 20010 Century Blvd Suite 200, Germantown MD 20874-1115. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wilson, Hettie Tabitha can be contacted via phone (240) 686-2300.Contact Information
Primary practice address
20010 Century Blvd Suite 200
Germantown MD 20874-1115
Phone: (240) 686-2300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA0365 | Texas |
Profile Details
| NPI number | 1467512608 |
|---|---|
| LBN Legal business name | Wilson, Hettie Tabitha |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 11th, 2006 |
| Last updated | Oct 11th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467512608 | NPPES |
| Texas | Other | 8Y8829 | BCBSTX |
| Texas | Other | 8N4694 | BCBSTX |
| Texas | Other | P00227237 | BCBSTX |
| Texas | MEDICAID | 182578802 | BCBSTX |
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