Individual
LAUREN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4425 PORTSMOUTH BLVD, SUITE 210E, CHESAPEAKE, VA 23321-2152
(757) 230-0056
(757) 809-5688
Mailing address
4425 PORTSMOUTH BLVD, SUITE 210E, CHESAPEAKE, VA 23321-2152
(757) 230-0056
(757) 809-5688
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HCO-161137
—
VA
Enumeration date
04/07/2014
Last updated
08/27/2015
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