Individual
ANGELA COLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC, PMHNP-BC
Contact information
Practice address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(707) 939-1100
(704) 939-1173
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
900452
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003724
—
NC
Enumeration date
02/13/2006
Last updated
09/16/2024
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