Organization
WILSON TELEHEALTH PREVENTIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTOINETTE MARIE WILSON RN-BSN, MHA, CRRN (OWNER)
(704) 974-9558
Entity
Organization
Contact information
Practice address
113 ADVENT DR, GROVER, NC 28073-8558
(704) 974-9558
Mailing address
113 ADVENT DR, GROVER, NC 28073-8558
(704) 974-9558
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
163WC0400X
Case Management Registered Nurse
—
—
163WC1500X
Community Health Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
—
174H00000X
Health Educator
—
—
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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