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Individual

TAKEYAH WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
1209 GREENBELT DR, GRIFFIN, GA 30224-4507
(478) 321-5894
Mailing address
1209 GREENBELT DR, GRIFFIN, GA 30224-4507
(478) 321-5894

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN302915
GA

Other

Enumeration date
07/22/2025
Last updated
07/28/2025
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