Individual
CHERYL MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
157 TWIN OAKS DRIVE, RACELAND, LA 70394
(985) 537-6823
(985) 537-5519
Mailing address
P. O. BOX B, 157 TWIN OAKS DRIVE, RACELAND, LA 70394
(985) 537-6823
(985) 537-5519
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN039291
LA
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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