Individual
MRS. JACLYN PLAICE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
6331 CARMEL RD STE 102, CHARLOTTE, NC 28226-8286
(803) 984-7420
Mailing address
PO BOX 604136, CHARLOTTE, NC 28260-4136
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5015179
NC
363LW0102X
Women's Health Nurse Practitioner
20082
SC
Other
Enumeration date
03/31/2016
Last updated
12/07/2023
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