Individual
MS. KRISTI JO WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P. - B.C
Contact information
Practice address
8293 OFFICE PARK DR., GRAND BLANC, MI 48439
(810) 694-3576
(810) 235-2721
Mailing address
8293 OFFICE PARK DR., GRAND BLANC, MI 48439
(810) 694-3576
(810) 760-0440
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704162286
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51149
BLUE SHIELD
MI
05
—
4762420
—
MI
Enumeration date
03/24/2007
Last updated
03/02/2017
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