Individual
KATRINA N WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 LEBANON RD, MURFREESBORO, TN 37129-1392
(256) 689-5583
Mailing address
423 COLETA DR, ANNISTON, AL 36206-8471
(256) 689-5583
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
3848G
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000000
CURRENTLY UNKNOWN
—
Enumeration date
12/07/2021
Last updated
12/07/2021
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