Individual
MS. LOLA MAE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5148 N 71ST ST, MILWAUKEE, WI 53218
(414) 464-0508
Mailing address
2720 WEST CHAMBERS, MILWAUKEE, WI 53210
(414) 873-4468
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
95436030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39988700
—
WI
Enumeration date
12/18/2006
Last updated
07/08/2007
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