Individual
ANDY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1375 ROBERTS DR, SUITE 205, JACKSONVILLE, FL 32250-3210
(904) 389-1010
(904) 389-1082
Mailing address
6195 LAKE GRAY BLVD, SUITE 4, JACKSONVILLE, FL 32244-5891
(904) 389-1010
(904) 389-1082
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP9225092
FL
Other
Enumeration date
08/27/2012
Last updated
02/28/2017
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