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Individual

MITCHELL WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
5885 HARRISON AVE STE 3500, CINCINNATI, OH 45248-1739
(513) 922-9660
(513) 347-2347
Mailing address
5885 HARRISON AVE STE 3500, CINCINNATI, OH 45248-1739
(513) 922-9660
(513) 347-2347

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.0037106
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0059662
OH
Enumeration date
07/22/2024
Last updated
12/04/2024
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