Individual
MARY KATHERINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-8269
(484) 628-5163
Mailing address
PO BOX 13579, READING, PA 19612-3579
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
100734
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN595348
PA
Other
Enumeration date
01/09/2014
Last updated
06/17/2019
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