Individual
CYNTHIA GAIL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
383 SMYTH AVE, ALLIANCE, OH 44601
(330) 821-3234
Mailing address
383 SMYTH AVE, ALLIANCE, OH 44601
(330) 821-3234
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN073312
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2273454
INDEPENDANT PROVIDER
OH
Enumeration date
03/18/2006
Last updated
07/08/2007
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