Individual
LA TISHA REED WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(432) 349-2710
Mailing address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(432) 349-2710
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
670887
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
670887
TX
Other
Enumeration date
08/26/2008
Last updated
11/26/2019
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