Individual
MRS. JEANINE PARKS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
1350 WALTON WAY, NEONATAL INTENSIVE CARE UNIT, AUGUSTA, GA 30901-2612
(706) 774-2591
Mailing address
341 SAINT JULIAN PL, NORTH AUGUSTA, SC 29860-8795
(803) 278-5502
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
RN145211
GA
Other
Enumeration date
07/16/2008
Last updated
07/28/2008
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