Individual
LEAH MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
230 S MAIN ST, SUITE 100, ORANGE, CA 92868-3851
(714) 541-0101
(714) 541-0450
Mailing address
11529 LA CANTERA TRL, FRISCO, TX 75033-1448
(631) 708-7624
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12645
CA
Other
Enumeration date
01/01/2008
Last updated
02/20/2014
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