Individual
MS. BRIDGET WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
134 HOMER AVE, CORTLAND, NY 13045-1206
(607) 756-3740
Mailing address
PO BOX 4224, ITHACA, NY 14852-4224
(607) 662-4056
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
341993
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
06/18/2017
Last updated
07/07/2017
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