Individual
MRS. ANTOINETTE MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN-BSN, MHA, CRRN
Contact information
Practice address
113 ADVENT DR, GROVER, NC 28073-8558
(704) 974-9558
Mailing address
113 ADVENT DR, GROVER, NC 28073-8558
(704) 974-9558
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
161324
NC
Other
Enumeration date
04/02/2021
Last updated
07/15/2021
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