Individual
MR. JASON EARL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
242 DEERFOOT DR, LONDON, KY 40741-8849
(606) 862-2686
Mailing address
242 DEERFOOT DR, LONDON, KY 40741-8849
(606) 862-2686
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3004775
KY
367500000X
Certified Registered Nurse Anesthetist
ARNP3143422
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306753000
—
FL
01
—
G3425
BCBS
FL
Enumeration date
12/07/2005
Last updated
09/05/2013
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