Individual
LISA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 JOHNSON ST, ALPENA, MI 49707-1434
(989) 358-7824
Mailing address
400 JOHNSON ST, ALPENA, MI 49707-1434
(989) 358-7824
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
4704206569
MI
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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