Individual
MS. SANDRA ROCHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.F.N.P.
Contact information
Practice address
3550 HIGHWAY 468 WEST, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8301
Mailing address
PO BOX 157A, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8301
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R856294
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05051897
—
MS
Enumeration date
06/14/2006
Last updated
06/08/2015
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