Individual
NICOLE M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, BCOP
Contact information
Practice address
3650 STEVE REYNOLDS BLVD, DULUTH, GA 30096-4506
(770) 931-6368
Mailing address
3650 STEVE REYNOLDS BLVD, DULUTH, GA 30096-4506
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
26021742A
IN
1835X0200X
Oncology Pharmacist
Primary
RPH025014
GA
Other
Enumeration date
09/04/2013
Last updated
07/17/2014
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