Individual
AMY MICHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1600 W AVENUE J, LANCASTER, CA 93534-2814
(661) 949-5000
Mailing address
3211 MARIPOSA AVE, PALMDALE, CA 93551-2534
(661) 992-6988
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95014054
CA
Other
Enumeration date
06/23/2020
Last updated
04/03/2023
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