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
2080 CHILD ST DEPT 5000, JACKSONVILLE, FL 32214-5000
(904) 542-7576
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9643378
FL
163W00000X
Registered Nurse
RN.446106
OH
363LF0000X
Family Nurse Practitioner
Primary
11033233
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.024771
OH
Other
Enumeration date
08/16/2019
Last updated
08/03/2026
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