Individual
ANGEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
104 ZEBULON CT, ROCKY MOUNT, NC 27804-2420
(252) 532-3300
Mailing address
812 E 11TH ST, ROANOKE RAPIDS, NC 27870-3952
(252) 532-3300
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
93453
NC
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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