Individual
DIXIE HUDSON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1623 13TH AVE, HUNTINGTON, WV 25701-3845
(304) 526-2243
(304) 522-9116
Mailing address
1340 HAL GREER BOULEVARD, ATTN: TAMMIE SILVA, HUNTINGTON, WV 25701-3800
(304) 526-2243
(304) 522-9116
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
20581
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067964000
—
WV
05
—
0773837
—
OH
05
—
74205550
—
KS
Enumeration date
06/30/2005
Last updated
02/20/2012
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