Individual
HEATHER BONNIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8620 OAK VIEW DR, CHATTANOOGA, TN 37421-4386
(423) 432-6745
Mailing address
1601 MCINTOSH CREEK CT, PHENIX CITY, AL 36867-1586
(334) 520-0645
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
RN196539
GA
367500000X
Certified Registered Nurse Anesthetist
RN196539
GA
Other
Enumeration date
09/15/2010
Last updated
04/10/2023
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