Individual
ANNIE J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3346 PROFESSIONAL PARK, OWENSBORO, KY 42303-4551
(270) 685-1066
(270) 685-0881
Mailing address
3346 PROFESSIONAL PARK, OWENSBORO, KY 42303-4551
(270) 852-8931
(270) 852-8924
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006996
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000818112
BCBS- BAPTIST HEALTH MADISONVILLE
KY
05
—
7100172820
—
KY
01
—
P01227101
RAILROAD MEDICARE
KY
Enumeration date
07/05/2011
Last updated
05/22/2015
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