Individual
TAMMY LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
4258 HIGHWAY 231 STE 5, LACEYS SPRING, AL 35754-6444
(256) 498-6500
(256) 970-2929
Mailing address
4258 HIGHWAY 231 STE 5, LACEYS SPRING, AL 35754-6444
(256) 498-6500
(256) 970-2929
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
1-127155
AL
363LA2100X
Acute Care Nurse Practitioner
1-127155
AL
363LA2100X
Acute Care Nurse Practitioner
13227637
AL
Other
Enumeration date
05/14/2021
Last updated
10/12/2022
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