Individual
GINA G WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1013 PROFESSIONAL CT, MANNING, SC 29102-2827
(803) 433-7444
(803) 433-7448
Mailing address
1013 PROFESSIONAL CT, MANNING, SC 29102-2827
(803) 433-7444
(803) 433-7448
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN562
SC
Other
Enumeration date
03/08/2006
Last updated
01/09/2014
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