Individual
MYLEAKIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 N 2ND ST APT 308, LEAVENWORTH, KS 66048-1541
(318) 453-5023
Mailing address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
237460
LA
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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