# NICOLE WILSON APRN PMHNP-BC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295421691
- **Authorized official:** NICOLE OLIVIA WILSON APRN, PMHNP-BC (NURSE PRACTITIONER)
- **Authorized official phone:** (701) 490-9553

## Contact information

- **Practice address:** 4320 RUMELY RD LOT 7, VELVA, ND 58790-7114
- **Practice address phone:** (701) 739-3094
- **Mailing address:** 4320 RUMELY RD LOT 7, VELVA, ND 58790-7114
- **Mailing address phone:** (701) 490-9553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/18/2023
- **Last updated:** 05/10/2023