Individual
MICHELLE ANTOINETTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45001 TANGLEWOOD DR, HAMMOND, LA 70401-4442
(832) 600-1935
Mailing address
45001 TANGLEWOOD DR, HAMMOND, LA 70401-4442
(832) 600-1935
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
32538
TX
Other
Enumeration date
11/26/2019
Last updated
05/16/2020
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