Individual
PAULA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
.550 POPE AVE, MUNSON ARMY HEALTH CENTER, FT. LEAVENWORTH, KS 66027-2332
(913) 648-6562
Mailing address
1217 TANGLEWOOD DR., LEAVENWOTH, KS 66048-2332
(913) 364-4419
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
24-34961-082
KS
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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