Individual
JUDITH RUTH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1645 CLARK AVE UNIT 116, LONG BEACH, CA 90815-3807
(562) 961-9146
(562) 961-9146
Mailing address
1645 CLARK AVE UNIT 116, LONG BEACH, CA 90815-3807
(562) 961-9146
(562) 961-9146
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1340
CA
Other
Enumeration date
06/07/2007
Last updated
11/12/2014
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