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Individual

MRS. CARRIE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1700 TREE LN, SUITE 110, SNELLVILLE, GA 30078-6782
(678) 775-1501
(678) 775-3585
Mailing address
1700 TREE LN, SUITE 110, SNELLVILLE, GA 30078-6782
(678) 775-1501
(678) 775-3585

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN251844
GA

Other

Enumeration date
09/28/2015
Last updated
09/28/2015
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