Individual
TAMMY MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
10 JODY LANE, HAMPSTEAD, NH 03841
(603) 329-6144
Mailing address
10 JODY LANE, HAMPSTEAD, NH 03841
(603) 329-6144
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
167939
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0320901
PROVIDER NUMBER
MA
Enumeration date
02/28/2007
Last updated
07/08/2007
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