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Individual
NICOLE DENISE WILSON
Active
Individual
NICOLE DENISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
14149
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513972
—
TN
01
—
4235392
BCBS
—
Enumeration date
05/04/2009
Last updated
08/26/2024
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