Individual
VERNETTE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 COMMERCE CT, CHESHIRE, CT 06410-1243
(203) 250-2361
Mailing address
PO BOX 3072, WESTPORT, CT 06880
(203) 615-4164
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
035902
CT
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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