Individual
THERESA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11608 BOSTON IVY LN, KNOXVILLE, TN 37932-1005
(720) 227-3491
Mailing address
11124 KINGSTON PIKE, KNOXVILLE, TN 37934-2863
(720) 227-3491
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
232971
TN
163WX1500X
Ostomy Care Registered Nurse
232971
TN
Other
Enumeration date
10/11/2025
Last updated
10/11/2025
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