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Individual
BRIAN JOSEPH WILSON
Active
Individual
BRIAN JOSEPH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
1-131315
AL
363LA2200X
Adult Health Nurse Practitioner
1-131315
AL
363LG0600X
Gerontology Nurse Practitioner
1-131315
AL
363LP2300X
Primary Care Nurse Practitioner
Primary
1-131315
AL
Other
Enumeration date
10/31/2019
Last updated
11/18/2021
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