Individual
AMY WAUGH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
900 VIRGINIA ST E STE 500, CHARLESTON, WV 25301-2805
(681) 313-4759
(844) 800-3954
Mailing address
54 VISTA VILLAGE DR, ONA, WV 25545-9544
(681) 203-4424
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33084
WV
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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