Individual
AKISHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
160 4TH ST, BRENTWOOD, NY 11717-4658
(631) 273-7105
(631) 273-7253
Mailing address
160 4TH ST, BRENTWOOD, NY 11717-4658
(631) 273-7105
(631) 273-7253
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
339950
NY
Other
Enumeration date
09/10/2015
Last updated
01/31/2023
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