Individual
MILDRED WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2410 METTE RD, WENTZVILLE, MO 63385-2108
(636) 578-8422
Mailing address
2410 METTE RD, WENTZVILLE, MO 63385-2108
(636) 578-8422
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2011016002
MO
Other
Enumeration date
12/19/2014
Last updated
12/19/2014
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