Individual
ELIZABETH A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
817 N EMPORIA ST, WICHITA, KS 67214-3709
(316) 268-5927
Mailing address
PO BOX 1897, WICHITA, KS 67201-1897
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1804
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201195360A
—
KS
Enumeration date
03/12/2013
Last updated
04/11/2018
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