Individual
ANITRA MICHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(254) 553-6024
Mailing address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
197391
TX
Other
Enumeration date
02/12/2021
Last updated
02/12/2021
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