Provider Demographics
NPI:1922600550
Name:WILSON, ROSEMARY MARIE
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:MARIE
Last Name:WILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:MARIE
Other - Last Name:TAKACS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:BELINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26250-7507
Mailing Address - Country:US
Mailing Address - Phone:304-203-5591
Mailing Address - Fax:
Practice Address - Street 1:106 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BELINGTON
Practice Address - State:WV
Practice Address - Zip Code:26250-7507
Practice Address - Country:US
Practice Address - Phone:304-203-5591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant