Individual
ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 328-3006
Mailing address
1305 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 328-3006
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
0061
SD
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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