Individual
KRISTY LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3364 W HWY 18, MANILA, AR 72442-0910
(870) 561-3300
(870) 561-3307
Mailing address
PO BOX 910, MANILA, AR 72442-0910
(870) 561-3300
(870) 561-3307
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A01766
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158285758
—
AR
Enumeration date
07/27/2006
Last updated
09/08/2016
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