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Individual

CYNTHIA R WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1313 N MAIN ST, BEAVER DAM, KY 42320-8957
(270) 298-9928
(270) 274-0134
Mailing address
PO BOX 148, HARTFORD, KY 42347-0148
(270) 504-1300
(270) 504-1380

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4410P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78012713
KY
Enumeration date
09/22/2005
Last updated
07/27/2023
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