Individual
JORDAN NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-2568
(855) 903-0985
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 581-1445
(573) 473-3794
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
2024003132
MO
Other
Enumeration date
02/13/2019
Last updated
07/21/2026
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