Individual
LATECIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
216 E KERR DR, MIDWEST CITY, OK 73110-4650
(405) 818-8583
(405) 407-2200
Mailing address
216 E KERR DR, MIDWEST CITY, OK 73110-4650
(405) 818-8583
(405) 407-2200
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0037311
OK
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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