Individual
JENI RACHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
8160 WALNUT HILL LN STE 113, DALLAS, TX 75231-4387
(214) 750-3770
(214) 750-3770
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1034104
TX
363LA2100X
Acute Care Nurse Practitioner
1034104
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
1034104
TX
Other
Enumeration date
04/07/2021
Last updated
08/20/2025
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