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Individual

AUTUM ELISSA WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
314 GROVE NECK RD, EARLEVILLE, MD 21919-3008
(302) 803-1910
Mailing address
314 GROVE NECK RD, EARLEVILLE, MD 21919-3008

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
L1-0070251
DE

Other

Enumeration date
07/17/2023
Last updated
07/17/2023
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