Individual
DR. LUCRETIA D. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
201 SIGMA DR STE 300, SUMMERVILLE, SC 29486-7722
(843) 418-8771
(970) 591-9592
Mailing address
201 SIGMA DR STE 300, SUMMERVILLE, SC 29486-7722
(843) 418-8771
(970) 591-9592
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
25299
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
25299
SC
Other
Enumeration date
09/14/2021
Last updated
07/08/2024
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