Individual
COLLEEN M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
228 BILLERICA RD, CHELMSFORD, MA 01824-3604
(978) 250-6100
(978) 250-6472
Mailing address
147 MILK ST, BOSTON, MA 02109-4806
(617) 421-2508
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
194864
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA53966
HARVARD PILGRIM
MA
Enumeration date
05/22/2006
Last updated
07/13/2010
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