Individual
DOROTHY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 S GLOSTER ST, HEART INSTITUTE, TUPELO, MS 38801-4934
(662) 377-3000
Mailing address
830 S GLOSTER ST, HEART INSTITUTE, TUPELO, MS 38801-4934
(662) 377-3000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901913
MS
Other
Enumeration date
12/30/2016
Last updated
01/16/2017
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