Individual
MRS. JOANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2480 LLEWELLYN AVE, FORT GEORGE G MEADE, MD 20755-5800
(301) 677-8641
Mailing address
7841 CRAIG ST, FORT GEORGE G MEADE, MD 20755-1112
(410) 695-5497
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
62834
WV
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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