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Individual
WENDY RENEE WILSON
Active
Individual
WENDY RENEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 083742 IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2372865
—
OH
Enumeration date
11/19/2007
Last updated
11/19/2007
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