Individual
MRS. ELLA NORA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 877-4420
Mailing address
706 E BRIDGEPORT ST, OKAWVILLE, IL 62271-1156
(618) 314-2696
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-006175
IL
Other
Enumeration date
11/29/2006
Last updated
08/02/2013
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