Individual
AUSTIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1355 BOGUE ST, EAST LANSING, MI 48824-6207
(800) 605-6424
Mailing address
1355 BOGUE ST, EAST LANSING, MI 48824-6207
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704329076
MI
Other
Enumeration date
03/23/2023
Last updated
05/30/2024
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