Individual
MS. DEBRA L. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, FNP
Contact information
Practice address
1444 FLORIDA AVE, SUITE 202, MODESTO, CA 95350-4400
(209) 524-1264
Mailing address
1444 FLORIDA AVE, SUITE 202, MODESTO, CA 95350-4400
(209) 524-1264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
417934
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9866
NURSING FURNISHING #
CA
Enumeration date
05/26/2006
Last updated
07/08/2007
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