Individual
MRS. LILLY RANDALL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
300 MOORESVILLE ROAD, KANNAPOLIS, NC 28081-0304
(704) 920-1000
(704) 920-1366
Mailing address
300 MOORESVILLE ROAD, KANNAPOLIS, NC 28081-0304
(704) 920-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201097
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZF0000097
—
NC
Enumeration date
02/26/2007
Last updated
11/01/2023
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