Individual
CHARLA F WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9075 SANDIDGE CENTER COVE, OLIVE BRANCH, MS 38654
(662) 895-4949
(662) 895-6746
Mailing address
6248 CAROLOT LN, BARTLETT, TN 38135-1196
(901) 372-8486
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R844603
MS
363LF0000X
Family Nurse Practitioner
Primary
5158
TN
Other
Enumeration date
10/17/2005
Last updated
05/16/2018
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