Individual
MS. DIANA LEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1170 NADINE DR, HEATH, OH 43056-9233
(740) 323-2631
Mailing address
1170 NADINE DR, HEATH, OH 43056-9233
(740) 323-2631
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.130027-M-IV
OH
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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