Individual
ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4870
(215) 955-6000
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4870
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP035331
PA
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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