Individual
DR. VALERIE RACHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
6633 E 540 RD, CLAREMORE, OK 74019
(918) 965-0220
Mailing address
350 S 40TH ST, MUSKOGEE, OK 74401-4915
(918) 683-0753
(918) 683-5677
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
95796
OK
207Q00000X
Family Medicine Physician
Primary
95796
OK
207Q00000X
Family Medicine Physician
F09171417
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255870465
—
OK
01
—
95796
RN
—
01
—
F09171417
NP-C
OK
Enumeration date
02/21/2017
Last updated
12/15/2021
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