WILDER CLINIC, LLC (NPI# 1750556148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750556148 |
| Entity Type | Organization |
| Organization Name | WILDER CLINIC, LLC |
| Practice Address |
201 Lakeview Rd Suite A Somerville TN 38068-9742 |
| Practice Telephone | 9018578925 |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |
| Authorized Official Name | MRS. PAULA WILDER (SHAREHOLDER) |
| Authorized Official Telephone | 9018578925 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN6154 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
201 LAKEVIEW RD SUITE A |
| City | SOMERVILLE |
| State | TN |
| Zip Code | 38068-9742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083919716 | Karrie Brooke King | Pharmacist | 201 Lakeview Rd, Suite C, Somerville, TN 38068-9742 | 2011-01-11 |
| 1619290657 | Doc Supply of West Tennessee, LLC | Durable Medical Equipment & Medical Supplies | 201 Lakeview Rd, Suite D, Somerville, TN 38068-9742 | 2010-03-04 |
| 1134357122 | West Clinic, PC | Specialist | 201 Lakeview Rd, Suite A, Somerville, TN 38068-9742 | 2009-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063850477 | Paula Lenore Walker | Nurse Practitioner | 25 Woodbridge, Suite A, Somerville, TN 38068 | 2013-06-07 |
| 1902026107 | Alliance Health Services, Inc | Home Health | 201 Lakeview Dr, Suite B, Somerville, TN 38068 | 2007-04-27 |
| 1730239997 | State of Tennessee | Public Health or Welfare | 90 Yum Yum Road, Somerville, TN 38068 | 2007-01-11 |
| 1366514697 | Cynthia D Elder | Pharmacy Technician | 13092 North Main Street, Summerville, TN 38068 | 2006-11-14 |
| 1275612053 | Bessie M Hoskins | Pharmacy Technician | 13092 North Main, Somerville, TN 38068 | 2006-11-03 |
| 1245319797 | Deborah Louise Davis | Pharmacy Technician | 8885 La Grange Rd, Somerville, TN 38068 | 2006-11-03 |
| 1891876868 | John David Cima | Dentist | 13190 N. Main St, Somerville, TN 38068 | 2006-10-18 |
| 1750478277 | Marie Middlecoff Stevens | Pharmacist | 13092 N Main Street, Super Drugs, Somerville, TN 38068 | 2006-10-06 |
| 1588675276 | Wilder Clinic | Family Medicine | 201 Lake View, Ste A Wilder Clinic, Sunerville, TN 38068 | 2006-08-10 |
| 1588687644 | Freds Stores of Tennessee Inc | Pharmacy | Highway 64 West, Somerville, TN 38068 | 2006-07-26 |
| Find all providers in zip 38068 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744111 | Sarah L Patches | Nurse Practitioner | 40 Central St Unit 2, Somerville, MA 02143-2826 | 2020-09-09 |
| 1790315331 | Zachariah Zehler | Nurse Practitioner | 6800 Wayne Trace Rd, Somerville, OH 45064-9483 | 2020-01-23 |
| 1700238508 | Medical East of Decatur Inc | Nurse Practitioner | 4166 Highway 36 E, Somerville, AL 35670-5803 | 2016-07-06 |
| 1629453121 | Emily Brown | Nurse Practitioner | 440 Foley St, Somerville, MA 02145-1213 | 2015-07-25 |
| 1316354236 | Meghan Glynn | Nurse Practitioner | 51 Woods Ave, Somerville, MA 02144-1118 | 2014-07-14 |
| 1063850477 | Paula Lenore Walker | Nurse Practitioner | 25 Woodbridge, Suite A, Somerville, TN 38068 | 2013-06-07 |
| 1710280391 | Allie Win Collignon | Nurse Practitioner | 750 Broadway Apt 3, Somerville, MA 02144-2143 | 2010-12-21 |
| 1164591566 | Elizabeth P Mcknight | Nurse Practitioner | 25 Woodbridge Rd, Somerville, TN 38068-1242 | 2006-11-07 |
| 1629018981 | Ashley O Pennington | Nurse Practitioner | 213 Lakeview Dr, Somerville, TN 38068 | 2006-06-07 |
| 1760098909 | Rebecca Watts | Nurse Practitioner | 110 Rehill Ave, Somerville, NJ 08876-2519 | 2020-09-22 |
| Find all providers in SOMERVILLE | ||||
| City | SOMERVILLE |
| Zip Code | 38068 |
Please comment or provide details below to improve the information on WILDER CLINIC, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.