Individual
EMILY DANIELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
CORNER OF SYDNEY AND LAMONT, ATTN: EXTENDED CARE, MOUNTAIN HOME, TN 37684
(423) 926-1171
Mailing address
101 DREWTANNER LN, JOHNSON CITY, TN 37604-6081
(423) 794-7064
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
14272
TN
Other
Enumeration date
11/30/2009
Last updated
11/30/2009
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