Individual
MS. JAZMIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7525 E TREASURE DR, NORTH BAY VILLAGE, FL 33141-4373
(305) 215-2984
Mailing address
7525 E TREASURE DR, NORTH BAY VILLAGE, FL 33141-4373
(305) 215-2984
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2019015909
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
01/11/2022
Last updated
01/11/2022
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