Individual
MARY WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3112 SHERIDAN DR, AMHERST, NY 14226-1904
(716) 773-6906
(716) 773-6868
Mailing address
PO BOX 548, GRAND ISLAND, NY 14072-0548
(716) 773-6906
(716) 773-6868
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
169062
NY
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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