Provider Demographics
NPI:1255213849
Name:WILSON, DESHEIKA
Entity type:Individual
Prefix:MS
First Name:DESHEIKA
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 TOWN CENTER PKWY APT 41021640
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8156
Mailing Address - Country:US
Mailing Address - Phone:504-442-2218
Mailing Address - Fax:
Practice Address - Street 1:1640 TOWN CENTER PKWY APT 41021640
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-8156
Practice Address - Country:US
Practice Address - Phone:504-442-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)