Individual
JENEVA JILL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1212 MARYS GROVE CHURCH RD, KINGS MOUNTAIN, NC 28086-9466
(980) 341-9535
Mailing address
1212 MARYS GROVE CHURCH RD, KINGS MOUNTAIN, NC 28086-9466
(980) 341-9535
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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