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Individual

MS. GINA ANN WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
7139 KENNY LN, DALLAS, TX 75230-3124
(214) 455-6149
Mailing address
7139 KENNY LN, DALLAS, TX 75230-3124
(214) 455-6149

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
577549
TX

Other

Enumeration date
01/16/2014
Last updated
01/16/2014
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