Individual
JERRY K. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-3131
Mailing address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN562072
PA
Other
Enumeration date
02/03/2006
Last updated
11/02/2007
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