Individual
MONIQUE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNS
Contact information
Practice address
5899 HARRISON AVENUE, MLC 6011, CINCINNATI, OH 45248
(513) 803-8200
(513) 803-8173
Mailing address
5899 HARRISON AVENUE, MLC 6011, CINCINNATI, OH 45248
(513) 803-8200
(513) 803-8173
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1092209
KY
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
3008200
KY
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
APRN.CNS.16189
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
06/22/2006
Last updated
07/16/2018
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