Individual
TAMIKA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4103 INDIAN PAINT BRUSH LN, HEARTLAND, TX 75126
(248) 719-8648
Mailing address
4103 INDIAN PAINT BRUSH LN, HEARTLAND, TX 75126
(248) 719-8648
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
1009084
TX
163WM0705X
Medical-Surgical Registered Nurse
Primary
1009084
TX
163WX0200X
Oncology Registered Nurse
1009084
TX
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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