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Provider Last Name Legal Name WILSON The last name of the provider if an individual.

A sole proprietorship may or may not have employees.

Provider Business Mailing Address State Name MO The State or Province name in the mailing address of the provider being identified.

She does not participate in medicare program and thus does not accept medicare assignments.

A field cannot contain all special characters.

The provider is physically located at: 301 SOVEREIGN CT STE 211 BALLWIN, MO 63011-4435, US BRANDI NICOLE WILSON PLPC can be reached at his practice location using the following numbers: Phone: 314-669-6426 Fax: The provider's official mailing address is: 4444 W PINE BLVD APT 416 SAINT LOUIS, MO 63108-2349, US The contact numbers associated with the mailing address are: Phone: 618-530-0613 Fax: Reference NPI Information.

This data element may contain the same information as ''Provider first line location address''.

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The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.

This data element may contain the same information as ''Provider location address telephone number''.