Individual
MS. RENEE D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNP
Contact information
Practice address
825 GRAHAM RD, BENTON, AR 72015-8975
(501) 317-6996
Mailing address
PO BOX 1270, BENTON, AR 72018-1270
(501) 317-6996
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
P00903
AR
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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