Organization
NICOLE WILSON APRN PMHNP-BC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE OLIVIA WILSON APRN, PMHNP-BC (NURSE PRACTITIONER)
(701) 490-9553
Entity
Organization
Contact information
Practice address
4320 RUMELY RD LOT 7, VELVA, ND 58790-7114
(701) 739-3094
Mailing address
4320 RUMELY RD LOT 7, VELVA, ND 58790-7114
(701) 490-9553
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
05/10/2023
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