Individual
MS. LOIS ANN WILDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
FAMILY GERIATRICS, 5348 DAVIS BLVD, NORTH RICHLAND HILLS, TX 76180
(817) 605-1707
(817) 605-1710
Mailing address
3632 ROLLING MEADOWS DR, BEDFORD, TX 76021-2625
(817) 858-9745
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
535611
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03689
TX STATE BOARD OF NURSE E
TX
Enumeration date
10/19/2006
Last updated
07/08/2007
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