Individual
BRETT M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
225 N WILLOW AVE STE 3, COOKEVILLE, TN 38501-2453
(931) 528-8999
(931) 520-7655
Mailing address
225 N WILLOW AVE STE 3, COOKEVILLE, TN 38501-2453
(931) 528-8999
(931) 520-7655
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
30000
TN
363LF0000X
Family Nurse Practitioner
APRN11009348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q079333
—
TN
Enumeration date
09/25/2020
Last updated
09/05/2023
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