Individual
RUTH C WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
134 S WOODS DR, ROCKLEDGE, FL 32955-3262
(321) 636-3066
(321) 636-2545
Mailing address
134 S WOODS DR, ROCKLEDGE, FL 32955-3262
(321) 636-3066
(321) 636-2545
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP898842
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000437200
—
FL
Enumeration date
09/25/2008
Last updated
09/19/2013
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