Provider Demographics
NPI:1801227921
Name:WILSON, MARIE KAMPER (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:KAMPER
Last Name:WILSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:MARIE
Other - Middle Name:ELIZABETH
Other - Last Name:KAMPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1806 APPALOOSA RD
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2708
Mailing Address - Country:US
Mailing Address - Phone:215-343-7998
Mailing Address - Fax:
Practice Address - Street 1:909 WALNUT ST
Practice Address - Street 2:C.O.B. ROOM 300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5211
Practice Address - Country:US
Practice Address - Phone:215-955-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-30
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013374363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care