Individual
CHRISTINE ANN WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
535 MAIN ST, OLEAN, NY 14760-1500
(716) 372-0141
(716) 372-6421
Mailing address
535 MAIN ST, OLEAN, NY 14760-1500
(716) 372-0141
(716) 372-6421
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
305970
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03427869
—
NY
Enumeration date
02/14/2012
Last updated
04/15/2013
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