Individual
DAMEKA RUNISE WILSON-VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3312 N OAK ST, VALDOSTA, GA 31605-1065
(229) 433-8526
Mailing address
2745 TYNDALL DR, VALDOSTA, GA 31602-1568
(229) 237-7627
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
332253
GA
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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