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Individual

JILL NICOLE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
5121 COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-6400
(801) 507-6491
Mailing address
1163 W 820 N, PROVO, UT 84601-1471
(801) 368-3968
(801) 377-6140

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
5140356-4405
UT
363LA2100X
Acute Care Nurse Practitioner
5140356-8900
UT

Other

Enumeration date
11/15/2011
Last updated
11/15/2011
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