Individual
KIMBERLY LOUISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2411 MARTIN LUTHER KING JR BLVD, EUGENE, OR 97401-5824
(541) 682-3608
Mailing address
275 E 42ND AVE, EUGENE, OR 97405-3409
(541) 335-9785
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
201703312RN
OR
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
201703312RN
OR
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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