Individual
LORETTA EVE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
488 W. MAIN STREET, STE 101, VAN, TX 75790-2608
(903) 963-6850
(903) 509-5835
Mailing address
488 W. MAIN STREET, STE 101, VAN, TX 75790-2608
(903) 963-6850
(903) 509-5835
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP121117
TX
Other
Enumeration date
12/07/2011
Last updated
03/25/2022
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