Individual
MRS. WENDY R WILGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 929-2584
(423) 722-2048
Mailing address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 929-2584
(423) 722-2048
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AON0000012298
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN0000012298
NURSE PRACTITIONER LICENS
TN
Enumeration date
11/14/2006
Last updated
07/08/2007
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