Individual
MCKENNA LEIGH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1080 OAKLAND AVE, PLAINFIELD, NJ 07060-3434
(908) 255-8626
Mailing address
1080 OAKLAND AVE, PLAINFIELD, NJ 07060-3434
(908) 255-8626
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
028008
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/05/2021
Last updated
07/21/2022
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