Individual
SARA WILSON
Active
Individual
SARA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
8546685-3102
UT
363L00000X
Nurse Practitioner
8546685-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
8546685-4405
UT
Other
Enumeration date
06/01/2020
Last updated
07/13/2021
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