Individual
CASSIE NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGCANP
Contact information
Practice address
1075 N CURTIS RD STE 101, BOISE, ID 83706-1348
(208) 302-2800
(208) 302-2825
Mailing address
PO BOX 31001-2360, PASADENA, CA 91110-2360
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
66379
ID
Other
Enumeration date
03/09/2022
Last updated
09/13/2024
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