Provider Demographics
NPI:1114089778
Name:WILSON, DARLENE DELORES (FNP,BC)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:DELORES
Last Name:WILSON
Suffix:
Gender:F
Credentials:FNP,BC
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Mailing Address - Street 1:4055 VALLEY VIEW LN STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5071
Mailing Address - Country:US
Mailing Address - Phone:972-715-3800
Mailing Address - Fax:855-984-5121
Practice Address - Street 1:SIGNIFY HEALTH LLC
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5071
Practice Address - Country:US
Practice Address - Phone:972-715-3800
Practice Address - Fax:855-984-5121
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5006211363LF0000X
NYF334434-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02624055Medicaid