Individual
LISA MAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
563 LANDINGS BLVD, ANN ARBOR, MI 48103-2715
(231) 445-2691
Mailing address
2488 COLONY WAY, YPSILANTI, MI 48197-7446
(231) 445-2691
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704313432
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704313432
MI
Other
Enumeration date
12/20/2019
Last updated
10/05/2021
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