Individual
JANICE LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2012 S PROMENADE BLVD, ROGERS, AR 72758
(479) 616-1485
(479) 239-0536
Mailing address
2012 S PROMENADE BLVD, ROGERS, AR 72758-9073
(479) 616-1485
(479) 239-0536
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005643
AR
Other
Enumeration date
05/16/2018
Last updated
04/02/2019
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