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Individual

BRANDI AILEEN WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1505 W SHERMAN AVE, VINELAND, NJ 08360-7059
(856) 641-8000
Mailing address
39 MORRIS DR, SICKLERVILLE, NJ 08081-4401

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR13777400
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00773200
NJ

Other

Enumeration date
10/05/2017
Last updated
11/13/2017
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