Individual
EMILY JEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-5050
Mailing address
4164 SINGEL DR SW, GRANDVILLE, MI 49418-2324
(616) 633-7395
(616) 685-5899
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704225570
MI
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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