Individual
MRS. MARLENE WILSON-LAVALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
500 HOSPITAL DR, WETUMPKA, AL 36092-1625
(334) 514-3713
Mailing address
500 HOSPITAL DR, WETUMPKA, AL 36092-1625
(334) 514-3713
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-089891
AL
363LF0000X
Family Nurse Practitioner
RN195646
AZ
Other
Enumeration date
08/07/2015
Last updated
07/06/2018
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