Individual
RAQUEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
309 N 5TH ST, WEST MEMPHIS, AR 72301-3213
(870) 260-7902
Mailing address
1500 OAKLAWN DR, WEST MEMPHIS, AR 72301-2996
(870) 260-7902
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
927570
TX
163W00000X
Registered Nurse
R08131
AR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
228158
AR
Other
Enumeration date
04/09/2024
Last updated
02/11/2026
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