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Individual

JACQUELYN L WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
58 KING AVE, FOLCROFT, PA 19032-1022
(610) 891-0171
Mailing address
58 KING AVE, FOLCROFT, PA 19032-1022
(610) 891-0171

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
L1-0012532
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
RN234466L
PA

Other

Enumeration date
09/27/2006
Last updated
02/17/2009
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