Individual
AMY L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
750 EAST ADAMS STREET, SYRACUSE, NY 13210
(315) 448-2713
(315) 744-1321
Mailing address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5111
(315) 703-5079
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
335606
NY
363L00000X
Nurse Practitioner
335606
NY
363LF0000X
Family Nurse Practitioner
335606
NY
Other
Enumeration date
11/04/2008
Last updated
02/20/2024
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