Individual
MRS. NICOLE ELAINE WILSON-CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
357 S GULPH RD, KING OF PRUSSIA, PA 19406-3136
(610) 892-3800
Mailing address
357 S GULPH RD, KING OF PRUSSIA, PA 19406-3136
(610) 892-3800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN0000011646
TN
363LP0200X
Pediatric Nurse Practitioner
841783
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP025184
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330021201
—
TX
Enumeration date
10/24/2006
Last updated
11/03/2024
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