Individual
MRS. SARAH K WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
210 OLD SPANISH TRAIL, GAUTIER, MS 39553
(228) 205-7700
(228) 205-7715
Mailing address
210 OLD SPANISH TRAIL, GAUTIER, MS 39553
(228) 205-7700
(228) 205-7715
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R866933
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09221069
—
MS
01
—
30250I4396
MEDICARE
MS
01
—
3431557
UHC
MS
01
—
5799138
CIGNA
MS
01
—
9740799
AETNA
MS
Enumeration date
02/29/2012
Last updated
07/18/2022
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