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JENNIFER LYNN WILSON CRNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1740455617

Individual Registrant:
 JENNIFER LYNN WILSON CRNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
199 LAKE BEND DR  ELMORE, AL 36025-1058 US
Tel: 334-714-3868  Fax: --

Contact information for business:
199 LAKE BEND DR  ELMORE, AL 36025-1058 US
Tel: 334-714-3868  Fax: --

Registration Information:
NPI: 1740455617
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
AL1-082885

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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