Individual
KIMBERLY T WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-NP
Contact information
Practice address
3481 AUSTIN PEAY HWY, MEMPHIS, TN 38128-3801
(901) 842-3174
Mailing address
901 N 7TH ST, WEST MEMPHIS, AR 72301-2001
(870) 735-4334
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
30266
TN
363LF0000X
Family Nurse Practitioner
217809
AR
Other
Enumeration date
02/06/2022
Last updated
08/02/2023
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