Individual
IRENE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
902979
MS
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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