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Individual

MARGUERITE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
99 TAVERN RD, MARTINSBURG, WV 25401-2890
(304) 263-7023
(304) 264-0508
Mailing address
PO BOX 1067, MARTINSBURG, WV 25402-1067
(304) 263-7023
(304) 264-0508

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
59685
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810000513
WV
Enumeration date
07/19/2005
Last updated
05/15/2013
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