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Individual

JERROD JONATHAN WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
101 QUARTZ DR STE 101, VILLA RICA, GA 30180-3256
(770) 836-9445
(770) 836-8808
Mailing address
101 QUARTZ DR STE 101, VILLA RICA, GA 30180-3256
(770) 836-9445
(770) 836-8808

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28262360A
IN
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP326207
GA

Other

Enumeration date
10/02/2020
Last updated
12/15/2025
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