Individual
BRANDY M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
11670 HIGHWAY 21 S, UNION, MS 39365-9198
(601) 540-6142
Mailing address
11670 HIGHWAY 21 S, UNION, MS 39365-9198
(601) 540-6142
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902640
MS
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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