Individual
NICOLE MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 747-6881
Mailing address
9500 EUCLID AVEUNE, CLEVELAND, OH 44195-0001
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.16417
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113609
—
OH
Enumeration date
09/30/2014
Last updated
10/11/2024
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