Individual
MRS. ADRIENE ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804
Mailing address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3014875
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100695770
—
KY
01
—
K346171
MEDICARE
KY
Enumeration date
07/14/2020
Last updated
03/07/2023
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