Individual
PATRICIA J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2002 BROOKSIDE DR, SUITE 300, KINGSPORT, TN 37660-4634
(423) 530-7900
(423) 232-8580
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 530-7900
(423) 232-8580
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
12895
TN
363LW0102X
Women's Health Nurse Practitioner
RN78573
TN
367A00000X
Advanced Practice Midwife
Primary
12895
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1532284
—
TN
05
—
1922063247
—
VA
Enumeration date
04/19/2006
Last updated
02/24/2025
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