Individual
DR. DONNA JEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4301 N UNIVERSITY AVE, C/O CARENCRO SCHOOL BASED HEALTH CENTER, CARENCRO, LA 70520-3905
(337) 521-7499
(337) 521-7498
Mailing address
4301 N UNIVERSITY AVE, C/O CARENCRO SCHOOL BASED HEALTH CENTER, CARENCRO, LA 70520-3905
(337) 521-7499
(337) 521-7498
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
07679R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1378542
—
LA
Enumeration date
07/25/2006
Last updated
11/21/2013
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