Individual
MS. CAROL J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
(314) 454-6051
(314) 454-4801
Mailing address
PO BOX 8221, 7425 FORSYTH, SAINT LOUIS, MO 63156-8221
(314) 454-6051
(314) 454-4801
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
048768
MO
Other
Enumeration date
07/18/2006
Last updated
12/28/2007
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