Individual
CRYSTAL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2120 S GREEN RD, SOUTH EUCLID, OH 44121-3349
(330) 718-5006
Mailing address
16117 CLIFTON BLVD, LAKEWOOD, OH 44107-2336
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0027557
OH
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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