Individual
CAROLYN DEANNA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 STOCKTON BLVD, SACRAMENTO, CA 95817-2215
(916) 453-5057
(916) 453-5038
Mailing address
2425 STOCKTON BLVD, SACRAMENTO, CA 95817-2215
(916) 453-5057
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
950866896
CA
163WM0705X
Medical-Surgical Registered Nurse
950866896
CA
163WP0200X
Pediatric Registered Nurse
950866896
CA
Other
Enumeration date
05/18/2021
Last updated
09/01/2023
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