Individual
MRS. JESSICA LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP-BC
Contact information
Practice address
436 W MAIN ST, HALE, MI 48739-9246
(989) 892-7722
Mailing address
436 W MAIN ST, HALE, MI 48739-9246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704227052
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083950976
—
MI
Enumeration date
12/20/2012
Last updated
10/06/2021
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