Individual
MRS. LINDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FMP
Contact information
Practice address
440 N BROAD ST, PHILADELPHIA, PA 19130-4015
(215) 471-2904
Mailing address
440 N BROAD ST, PHILADELPHIA, PA 19130-4015
(215) 471-2904
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
SP008244
PA
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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