Individual
MRS. ELAINE SUSAN WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ARNP/CNM
Contact information
Practice address
307 BOATNER RD, FAMILY HEALTH CLINIC/96TH MDG, SUITE 114, EGLIN AFB, FL 32542-1391
(850) 883-8763
Mailing address
238 COUNTRY CLUB RD, SHALIMAR, FL 32579-2216
(850) 609-0454
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
ARNP9201126
FL
Other
Enumeration date
03/28/2006
Last updated
07/08/2007
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