Individual
SHIRLEY CRAWFORD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5105 BENNING RD, JACKSONVILLE, FL 32254-3610
(904) 487-3949
(904) 580-5805
Mailing address
5105 BENNING RD, JACKSONVILLE, FL 32254-3610
(904) 487-3949
(904) 580-5805
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
238327
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024749500
—
FL
Enumeration date
06/29/2007
Last updated
04/19/2022
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