Individual
CHERYL K WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1805 27TH ST, PORTSMOUTH, OH 45662-2640
(740) 356-8231
(740) 356-3686
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-6942
(740) 356-7851
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.13766-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071641
—
OH
Enumeration date
08/30/2012
Last updated
12/16/2020
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