Individual
MR. STEPHEN CHRISTOPHER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
8222 HIGHWAY 51 NORTH, MILLINGTON, TN 38053
(901) 873-4242
(901) 873-4269
Mailing address
8222 HIGHWAY 51 NORTH, MILLINGTON, TN 38053
(901) 873-4242
(901) 873-4269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
16598
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
APN016598
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530867
—
TN
Enumeration date
03/26/2012
Last updated
09/23/2022
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