Individual
ADAM A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-1500
(386) 231-1598
Mailing address
132 MOULTRIE CROSSING LN, ST AUGUSTINE, FL 32086-5242
(904) 687-8964
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11004458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104733000
—
FL
Enumeration date
10/12/2019
Last updated
03/10/2026
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