Individual
ROBIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
122 GORDON COMMERCIAL DR STE C, LAGRANGE, GA 30240-5754
(706) 845-4045
(706) 845-4367
Mailing address
789 WILLIAMSON RD, TALLAPOOSA, GA 30176-3936
(770) 634-8528
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN063310
GA
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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