Bradley Russell Wilson, FNP | |
22101 Moross Rd, Detroit, MI 48236-2148 | |
(313) 343-3660 | |
Not Available |
Full Name | Bradley Russell Wilson |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 22101 Moross Rd, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508339987 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 470429662 (Michigan) | Primary |
Entity Name | Ascension St John Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043478910 PECOS PAC ID: 3173424082 Enrollment ID: O20040115000409 |
Mailing Address | Practice Location Address |
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Bradley Russell Wilson, FNP 36251 Alfred St, New Baltimore, MI 48047-2106 Ph: (586) 840-6016 | Bradley Russell Wilson, FNP 22101 Moross Rd, Detroit, MI 48236-2148 Ph: (313) 343-3660 |
Catherine Ann Wenz, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16411 Curtis St, Detroit, MI 48235 Phone: 313-838-6822 | |
Mikayla Spica, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600 | |
Amber Marroquin, NNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 800-653-6568 | |
Elena M Darby, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 313-343-4921 Fax: 313-343-7091 | |
Mrs. Ines Hurley, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3950 Beaubien St, Detroit, MI 48201 Phone: 313-745-5437 | |
Nicole Woznicki, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3901 Chrysler Dr, Detroit, MI 48201 Phone: 313-966-7601 | |
Kathleen Mclaughlin, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3980 John R, Detroit, MI 48201 Phone: 888-362-2500 |