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Individual

KATHERINE RENEE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
600 PROFESSIONAL DR, SUITE 210, LAWRENCEVILLE, GA 30045-7651
(770) 963-8030
(770) 339-8086
Mailing address
600 PROFESSIONAL DR, SUITE 210, LAWRENCEVILLE, GA 30045-7651
(770) 963-8030
(770) 339-9577

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN157974
GA

Other

Enumeration date
06/28/2006
Last updated
07/08/2007
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