Individual
SUSANNAH ALYSE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8585 PICARDY AVE, BATON ROUGE, LA 70809-3748
(956) 299-3727
Mailing address
124 JEANSONNE ST, PINEVILLE, LA 71360-5060
(318) 729-0501
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
229744
LA
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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