Individual
JANICE MAY WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2183 E HIGHWAY 5, CARROLLTON, GA 30116-7716
(770) 314-2018
Mailing address
2183 E HIGHWAY 5, CARROLLTON, GA 30116-7716
(770) 314-2018
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
150905
GA
Other
Enumeration date
09/26/2012
Last updated
06/11/2016
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