Individual
KRISTEN NICOLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
366 BELLINGHAM DR, THOMASVILLE, GA 31792-8663
(229) 403-4644
Mailing address
366 BELLINGHAM DR, THOMASVILLE, GA 31792-8663
(229) 403-4644
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN238721
GA
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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