Individual
LATOYA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9826 DECATUR RD, MIDDLE RIVER, MD 21220-3777
(410) 240-0174
Mailing address
9826 DECATUR RD, MIDDLE RIVER, MD 21220-3777
(410) 240-0174
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F03240036
MD
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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