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Individual
MRS. TEYONKA T. WILSON
Active
Individual
MRS. TEYONKA T. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA65404
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125775B
—
GA
05
—
003125775C
—
GA
05
—
003125775D
—
GA
05
—
003125775E
—
GA
01
—
P01292129
RAILROAD MEDICARE
GA
Enumeration date
12/08/2008
Last updated
10/02/2025
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