Individual
JODIAN MARIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
20 PROSPECT AVE STE 905, HACKENSACK, NJ 07601-1974
(201) 417-4910
Mailing address
20 PROSPECT AVE STE 905, HACKENSACK, NJ 07601-1974
(201) 417-4910
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
26NJ00835500
NJ
Other
Enumeration date
07/25/2018
Last updated
05/21/2019
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