Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eva Dominie Wilson

Individual provider Gerontology Nurse Practitioner · NPI 1063084127

Eva Dominie Wilson is a Nurse Practitioner in Minneapolis, Minnesota. Qualified in 2022, 4 years ago. Practices with Geriatric Services of Minnesota LLC, a 43-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2021

Practice location Address checks out

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone: (763) 587-7737
Fax: (763) 587-7069
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 8244 (MN)

Record details

NPI number1063084127
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 16, 2021
Last updated in NPPESMay 21, 2024
Certification dateMay 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Geriatric Services Of Minnesota Llc — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Minneapolis