Individual
MRS. JOLIE LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1449 TEMPLE RD, BREMEN, GA 30110-2378
(770) 537-2367
(770) 537-1203
Mailing address
1449 TEMPLE RD, BREMEN, GA 30110-2378
(770) 537-2367
(770) 537-1203
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN220869
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-155609
AL
Other
Enumeration date
05/26/2015
Last updated
01/05/2022
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