Individual
MRS. ELISABETH GREBER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
845 OLIVE ST STE B, SHREVEPORT, LA 71104-2143
(318) 220-7047
(318) 222-2159
Mailing address
522 NORTHPARK DR, BOSSIER CITY, LA 71111-2210
(318) 549-9665
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06215
LA
Other
Enumeration date
02/21/2011
Last updated
05/08/2015
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