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Individual

KAROLYN ANGELA WILDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, PMHNP

Contact information

Practice address
101 LEWIS ST STE 2, PETOSKEY, MI 49770
(231) 881-1047
Mailing address
101 LEWIS ST STE 2, PETOSKEY, MI 49770
(231) 881-1047

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
4704191311
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704191311
MI

Other

Enumeration date
10/22/2021
Last updated
01/09/2023
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