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Individual

CHERYL LINN WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
17417 BRIDGE HILL CT, TAMPA, FL 33647-3467
(813) 972-7900
(813) 355-5035
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(813) 528-4975

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9186217
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004587600
FL
01
P01620175
FMC-RR MEDICARE
FL
01
Y09YW
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/05/2006
Last updated
04/26/2016
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