Individual
AMANDA IRONS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3900 BROWNING PL, SUITE 101, RALEIGH, NC 27609-6508
(919) 781-9650
Mailing address
4600 BAYSPRING LN, RALEIGH, NC 27613-3828
(919) 624-0091
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02183
NC
363AM0700X
Medical Physician Assistant
0010-02183
NC
Other
Enumeration date
02/05/2010
Last updated
09/18/2021
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