Individual
ATHINA KAY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
17121 ERWIN LN, HUNTINGTON BEACH, CA 92647-5504
(714) 614-8219
Mailing address
17121 ERWIN LN, HUNTINGTON BEACH, CA 92647-5504
(714) 614-8219
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
263156
CA
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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