Individual
DEBRA ELIZABETH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6103 WESTFIELD AVE, PENNSAUKEN, NJ 08110-1754
(856) 486-9097
Mailing address
222 CYPRESS AVE APT 1, WOODLYNNE, NJ 08107-2122
(856) 375-4246
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NPO4515300
NJ
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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