Individual
SHAYE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
10700 S STATE HIGHWAY 43, SOUTH WEST CITY, MO 64863-7272
(417) 762-5250
(177) 625-2524
Mailing address
10700 S STATE HIGHWAY 43, SOUTH WEST CITY, MO 64863-7272
(417) 762-5250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2019012514
MO
363L00000X
Nurse Practitioner
A006255
AR
363LF0000X
Family Nurse Practitioner
Primary
112102
OK
Other
Enumeration date
10/10/2018
Last updated
03/30/2022
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