Individual
MRS. JEANETTE ELIZABETH WILSON DEFELICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1240 HUFFMAN MILL ROAD, BURLINGTON, NC 27215-8700
(336) 538-8471
(336) 538-8161
Mailing address
PO BOX 602598, CHARLOTTE, NC 28260-2598
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004905
—
NC
Enumeration date
01/08/2011
Last updated
09/27/2021
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