Individual
VERNA E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 HERITAGE CIR, PAWNEE, OK 74058-3744
(918) 762-6638
Mailing address
1201 HERITAGE CIR, PAWNEE, OK 74058-3744
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0067029
OK
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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