Individual
MRS. MICHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2202 N JOHN B DENNIS HWY STE 310, KINGSPORT, TN 37660-5904
(423) 246-4155
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
166081
NC
363L00000X
Nurse Practitioner
Primary
21533
TN
363LF0000X
Family Nurse Practitioner
5004374
NC
Other
Enumeration date
06/04/2009
Last updated
01/31/2024
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