Individual
COLLEEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
550 S CLAY ST, INDEPENDENCE, CA 93526
(760) 878-0324
Mailing address
PO BOX A, INDEPENDENCE, CA 93526-0601
(760) 878-0345
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
669955
CA
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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