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Individual
MRS. AMY MARIE WILSON
Active
Individual
MRS. AMY MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A-GNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28287019A
IN
163W00000X
Registered Nurse
RN329269
GA
363LG0600X
Gerontology Nurse Practitioner
1152261
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
4704247296
MI
Other
Enumeration date
09/17/2014
Last updated
10/12/2025
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