Individual
AMANDA JO WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4507 SANTA ROSA DR, MIDLAND, TX 79707-2260
(432) 683-8516
Mailing address
4507 SANTA ROSA DR, MIDLAND, TX 79707-2260
(432) 683-8516
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1003962
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003968
TEXAS NURSING BORARD
TX
Enumeration date
07/17/2020
Last updated
07/15/2022
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