Individual
EVA DOMINIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3433 BROADWAY ST NE STE 300, MINNEAPOLIS, MN 55413-1761
(763) 587-7737
(763) 587-7069
Mailing address
8198 PALMGREN AVE NE, OTSEGO, MN 55330-7224
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
8244
MN
Other
Enumeration date
07/16/2021
Last updated
05/21/2024
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