Individual
MRS. CAROL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8796 N PAULETTES PL, BILOXI, MS 39532-7410
(228) 392-3095
(228) 392-3095
Mailing address
8796 N PAULETTES PL, BILOXI, MS 39532-7410
(228) 392-3095
(228) 392-3095
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P165786
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770265
—
MS
Enumeration date
10/06/2006
Last updated
07/09/2007
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