Provider Demographics
NPI:1710718507
Name:ANTHONY, WILMA D (RN)
Entity type:Individual
Prefix:MRS
First Name:WILMA
Middle Name:D
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:WILMA
Other - Middle Name:D
Other - Last Name:ANTHONY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, RN
Mailing Address - Street 1:10921 REED HARTMAN HWY STE 226
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2830
Mailing Address - Country:US
Mailing Address - Phone:513-686-1560
Mailing Address - Fax:
Practice Address - Street 1:10921 REED HARTMAN HWY STE 226
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2830
Practice Address - Country:US
Practice Address - Phone:513-686-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251106163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse