Individual
JENNA R WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 ROSE STREET, LEXINGTON, KY 40536-0001
(812) 664-8286
Mailing address
214 CHARLOTTE DR, BOWLING GREEN, KY 42104-7757
(812) 664-8286
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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