Individual
LILI WAT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1309 W 17TH ST STE 101, SIOUX FALLS, SD 57104-8805
(605) 328-8000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP001524
SD
363LF0000X
Family Nurse Practitioner
342333
NY
Other
Enumeration date
10/02/2017
Last updated
09/18/2019
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