Wilson, Kim Dittis
Wilson, Kim Dittis is an individual health care provider with primary practice located at 900 E Michigan Ave Ste 105 , Jackson MI 49201-2490. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wilson, Kim Dittis can be contacted via phone (517) 782-3190.Contact Information
Primary practice address
900 E Michigan Ave Ste 105
Jackson MI 49201-2490
Phone: (517) 782-3190
Fax: (517) 782-1223
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 4704131316 | Michigan |
Profile Details
| NPI number | 1134169311 |
|---|---|
| LBN Legal business name | Wilson, Kim Dittis |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Mar 17th, 2018 - about 8 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 | 1134169311 | NPPES |
| Michigan | Other | 500017755 | RR MEIDCARE |
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