Individual
HAILEY L. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 BEVER GRADE, LAPWAI, ID 83554-0367
(208) 843-2271
(208) 621-4995
Mailing address
111 BEVER GRADE, LAPWAI, ID 83554-0367
(208) 843-2271
(208) 621-4995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5271551
ID
207Q00000X
Family Medicine Physician
Primary
60471450
WA
Other
Enumeration date
05/28/2014
Last updated
01/29/2026
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