Individual
CAROL LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1602 MAMYE JANE DR, KILLEEN, TX 76542-6154
(254) 462-5912
Mailing address
1602 MAMYE JANE DR, KILLEEN, TX 76542-6154
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
530939
TX
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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