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Individual

MISS BOBBIE RAYLENE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, ARNP, FNP-C

Contact information

Practice address
4222 22ND AVE S # 531292, ST PETERSBURG, FL 33711-3001
(720) 470-4600
Mailing address
PO BOX 531292, ST PETERSBURG, FL 33747-1292
(720) 470-4600

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN-81179
HI
163WC0200X
Critical Care Medicine Registered Nurse
RN840716
NV
163WC0200X
Critical Care Medicine Registered Nurse
RN9454720
FL
363LF0000X
Family Nurse Practitioner
253366
AZ
363LF0000X
Family Nurse Practitioner
APRN-2884
HI
363LF0000X
Family Nurse Practitioner
APRN11006391
FL
363LF0000X
Family Nurse Practitioner
APRN62303
NM
363LF0000X
Family Nurse Practitioner
CNP-840716
NV
363LF0000X
Family Nurse Practitioner
CNP66532
ID
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-174427
MT

Other

Enumeration date
03/05/2020
Last updated
02/10/2024
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