Individual
KRISTIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8132 CORDOVA RD, CORDOVA, TN 38016
(901) 405-6470
(901) 747-2338
Mailing address
311 S 3RD ST, UNION CITY, TN 38261-3723
(731) 507-0062
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13402
TN
363L00000X
Nurse Practitioner
A810389
MS
363LF0000X
Family Nurse Practitioner
13402
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513081
—
TN
Enumeration date
09/17/2008
Last updated
09/19/2019
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