Provider Demographics
NPI:1437599180
Name:WILSON, BARBARA DENISE
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:DENISE
Last Name:WILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 SUNSET BLVD # 2006
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-5914
Mailing Address - Country:US
Mailing Address - Phone:704-852-0835
Mailing Address - Fax:
Practice Address - Street 1:1304 SUNSET BLVD # 2006
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-5914
Practice Address - Country:US
Practice Address - Phone:704-852-0835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker