Individual
JANENA GRACE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
806 MANVEL AVE, CHANDLER, OK 74834
(405) 258-9955
(405) 258-9930
Mailing address
806 MANVEL AVE, CHANDLER, OK 74834-3858
(405) 258-9955
(405) 258-9930
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
86757
OK
Other
Enumeration date
06/14/2011
Last updated
06/07/2018
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