Individual
DIANE D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3000 HERRING AVE, WACO, TX 76708-3239
(254) 741-1185
Mailing address
3225 WILBANKS DR, WACO, TX 76705-5069
(254) 875-2089
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
238832
TX
Other
Enumeration date
08/16/2005
Last updated
03/09/2009
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