Individual
CAITLIN ELLIOTT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
150 D ST, GREER, SC 29651-6930
(864) 879-1948
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20574
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6045
—
SC
01
—
SCA4286067
MEDICARE PIN
SC
Enumeration date
01/25/2017
Last updated
10/04/2019
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