Lisa Ruth Wilson AGNP

NPI 1710307889 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1710307889
Gender Female
Enumeration Date 04/16/2014
Last Updated 04/16/2014
Entity Type Individual
Active Over 3 years ago
Practice Location
324 W 5TH ST
WASHINGTON MO, 63090-2306, US
Phone (636) 795-0342
Business Location
WARRENTON MO, 63383-5883, US
Phone (636) 795-0342
Taxonomy Code 363LA2200X
License State Missouri
License Number 2014010130
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According to our database, Lisa Ruth Wilson AGNP NPI is 1710307889, taxonomy code is 363LA2200X and license number is 2014010130, license state is located at Missouri. Lisa Ruth Wilson AGNP physically located at 324 W 5th St, Washington MO, 63090-2306. NPI Number Lisa Ruth Wilson AGNP has the Individual type.

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1710307889 NPI number is provided on an as is basis without warranty of any kind. 1710307889 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Ruth Wilson AGNP are for informational purposes only.