Individual
ELIZABETH ROBIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.M.
Contact information
Practice address
916 S BROAD ST, THOMASVILLE, GA 31792-6113
(229) 226-8800
(229) 226-1660
Mailing address
360 COLLEGE ST, BLAKELY, GA 39823-2554
(229) 723-2660
(229) 723-5969
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN123110
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217056732A
—
GA
05
—
217056732B
—
GA
01
—
RN123110
LICENSE NUMBER
GA
Enumeration date
06/28/2007
Last updated
05/14/2015
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