Individual
MRS. JOANN MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN-BC
Contact information
Practice address
2023 VADALABENE DR STE 300, MARYVILLE, IL 62062-5846
(618) 288-6722
(618) 288-2077
Mailing address
916 TALON DR, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
151656
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
209008172
IL
Other
Enumeration date
09/10/2008
Last updated
12/05/2019
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