Individual
BRANDON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4475
(220) 564-4412
Mailing address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4475
(220) 564-4412
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
026226
OH
363LF0000X
Family Nurse Practitioner
026226
OH
Other
Enumeration date
02/21/2020
Last updated
12/15/2022
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