Individual
MRS. LARA S. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
6675 HOLMES RD, STE 550, KANSAS CITY, MO 64131-1150
(816) 363-7710
Mailing address
6119 RUSSELL ST, MISSION, KS 66202-3220
(816) 838-1978
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2008020256
MO
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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