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Individual

DR. KATELYN JEANNE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 846-3305
Mailing address
1030 HIGHLANDS PLAZA DR E APT 202, SAINT LOUIS, MO 63110-1344
(314) 225-8083

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary

Other

Enumeration date
04/12/2019
Last updated
04/12/2019
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