Individual
MRS. SHONDELL A WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(772) 781-7772
Mailing address
13083 72ND CT N, WEST PALM BEACH, FL 33412-1474
(954) 547-8535
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5173216
FL
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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