Individual
ELLEN LOUISE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CCM
Contact information
Practice address
620 CHESTNUT HILL RD, DAYVILLE, CT 06241
(860) 234-1310
Mailing address
PO BOX 792, 620 CHESTNUT HILL RD, DAYVILLE, CT 06241
(860) 234-1310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
081384
CT
163WC0400X
Case Management Registered Nurse
Primary
081384
CT
163WH0200X
Home Health Registered Nurse
081384
CT
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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