Individual
MRS. ANDREA NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-8716
(904) 546-7065
Mailing address
7050 AIR DEPOT BLVD BLDG 1094, TINKER AFB, OK 73145-8716
(405) 734-2778
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.446106
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.024771
OH
Other
Enumeration date
08/16/2019
Last updated
04/10/2024
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