Individual
MS. KIMBERLEY ALEXANDRIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 NIAGARA ST, BUFFALO, NY 14201-2135
(716) 859-5600
Mailing address
78 RAINTREE IS, APT #8, TONAWANDA, NY 14150-9539
(716) 289-5608
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
30305333
NY
363LW0102X
Women's Health Nurse Practitioner
42420977
NY
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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