Individual
KERRI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6114 DELMAR ST, FAIRWAY, KS 66205-3232
(913) 742-0828
Mailing address
6114 DELMAR ST, FAIRWAY, KS 66205-3232
(913) 742-0828
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2021050330
MO
363L00000X
Nurse Practitioner
Primary
53-80804-072
KS
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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