Individual
KATRINA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3486 PEACH ORCHARD RD STE 200, AUGUSTA, GA 30906-5215
(706) 828-8000
Mailing address
36 PEMBERTON CV, JACKSON, TN 38305-5514
(731) 394-1145
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11001658
FL
363L00000X
Nurse Practitioner
Primary
GAA-NP001025
GA
363LF0000X
Family Nurse Practitioner
APRN11001658
FL
363LF0000X
Family Nurse Practitioner
GAA-NP001025
GA
Other
Enumeration date
03/06/2019
Last updated
09/19/2024
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