Individual
MISS HILLARY DAWN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
436 JACOBS HILL RD, SHINGLEHOUSE, PA 16748-5118
(585) 307-6253
(814) 697-7626
Mailing address
436 JACOBS HILL RD, SHINGLEHOUSE, PA 16748-5118
(585) 307-6253
(814) 697-7626
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10309943
NY
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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