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Individual

MRS. LAURIE DODGE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, ANP-BC, GNP-BC

Contact information

Practice address
2150 PENNSYLVANIA AVE NW, WASHINGTON, DC 20037-3201
(202) 741-3333
(202) 741-2791
Mailing address
2150 PENNSYLVANIA AVE NW, #5-411, WASHINGTON, DC 20037-3201
(202) 742-3398
(202) 741-3396

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN1013020
DC
363LG0600X
Gerontology Nurse Practitioner
Primary
RN1013020
DC

Other

Enumeration date
03/10/2008
Last updated
03/10/2008
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