Individual
JENNIFER NICOLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5240 MABELVALE PIKE, LITTLE ROCK, AR 72209-1961
(501) 447-4805
Mailing address
142 HIBISCUS DR, MAUMELLE, AR 72113-5816
(501) 447-4805
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R076867
AR
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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