Individual
JOANNA LEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3966 W 38TH ST, CASPER, WY 82604-4293
(307) 267-6642
Mailing address
3966 W 38TH ST, CASPER, WY 82604-4293
(307) 267-6642
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
36659
WY
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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