Individual
LICINDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
325 NEW CASTLE RD, BUTLER, PA 16001-2418
(724) 637-3170
Mailing address
187 WEBB RD, BUTLER, PA 16001-9707
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN226441L
PA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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