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Individual
MRS. LAURA RENAE WILSON
Active
Individual
MRS. LAURA RENAE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
004365
CT
363LF0000X
Family Nurse Practitioner
701633
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
RN247115
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275620551
NPI - ROBERTSON COUNTY CHC
TX
05
—
154467803
—
TX
01
—
1649265646
NPI- BRYAN- COLLEGE STATION CHC
TX
01
—
1821185299
NPI - BVCAA
TX
Enumeration date
05/15/2007
Last updated
03/06/2019
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