Individual
CANDICE MELODY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
63 RILEY RD, CELEBRATION, FL 34747-5419
(407) 930-6900
(321) 203-4669
Mailing address
63 RILEY RD, CELEBRATION, FL 34747-5419
(407) 930-6900
(321) 203-4669
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9327498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24929100
—
FL
Enumeration date
02/06/2017
Last updated
12/26/2023
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