Individual
HALEY B. WILSON
Active
Individual
HALEY B. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3272
GA
363AM0700X
Medical Physician Assistant
Primary
003272
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000357A
—
GA
05
—
100000358A
—
GA
05
—
100000359B
—
GA
05
—
100000359C
—
GA
01
—
10032996
AMERIGROUP
GA
01
—
303673
WELLCARE
GA
01
—
303676
WELLCARE
GA
01
—
303679
WELLCARE
GA
01
—
303686
WELLCARE
GA
Enumeration date
02/06/2006
Last updated
08/17/2023
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