Individual
MS. LARA NOEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
68 WEST DOMINION BOULEVARD, COLUMBUS, OH 43214
(770) 251-2060
(678) 854-9235
Mailing address
68 WEST DOMINION BOULEVARD, COLUMBUS, OH 43214
(770) 251-2060
(678) 854-9235
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
RN.398740-COA.15479
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN192709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
842523571A
—
GA
Enumeration date
02/19/2010
Last updated
10/10/2014
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