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Individual
PROF. JULIE M WILSON
Active
Individual
PROF. JULIE M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS00582
RI
363L00000X
Nurse Practitioner
PS00582
RI
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN00315
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25670-4
BLUE CROSS/BLUE SHIELD
RI
01
—
410199
BLUECHIP
RI
Enumeration date
07/10/2006
Last updated
01/27/2020
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