Individual
MRS. KIMBERLY ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN-CNP, NP-C
Contact information
Practice address
4333 S 172ND EAST AVE, TULSA, OK 74134-7281
(918) 355-0491
Mailing address
4333 S 172ND EAST AVE, TULSA, OK 74134-7281
(918) 355-0491
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
85620
OK
Other
Enumeration date
09/24/2016
Last updated
02/08/2017
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