Individual
TONYA GAYLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3831 CEDAR RIDGE DR, NORMAN, OK 73072-4623
(405) 912-4585
Mailing address
3801 BELHAVEN CIRCLE, NORMAN, OK 73072
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
59422
OK
Other
Enumeration date
04/05/2011
Last updated
12/12/2012
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