Individual
EVELYN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
23270 NORWOOD ST, OAK PARK, MI 48237-2272
(248) 763-1692
Mailing address
23270 NORWOOD ST, OAK PARK, MI 48237-2272
(248) 763-1692
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703043981
MI
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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