Individual
MRS. BETTY J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2927 HIGHWAY 66 S, ROGERSVILLE, TN 37857-5169
(423) 272-6969
Mailing address
PO BOX 850, ROGERSVILLE, TN 37857-0850
(423) 272-6969
(423) 921-6920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000005031
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33416361
—
TN
Enumeration date
03/04/2008
Last updated
12/30/2009
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