Individual
TERESA D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
105 BELVIEW RD, LEESVILLE, LA 71446-2902
(337) 238-6431
(337) 238-7070
Mailing address
PO BOX 1526, LEESVILLE, LA 71496-1526
(337) 238-6431
(337) 238-7070
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN103870
LA
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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