| Doctor Name: | CHRISTINE A WILSON |
| NPI Number: | 1033467618 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 4704212774 |
| Business Practice Address: | 12265 James St Holland, MI - 494248613 |
| Business Phone Number: | 6164945698 |
| Business Fax Number: | |
| Mailing Address: | 12265 James St, HOLLAND |
| State: | MI |
| Postal Code: | 494248613 |
| Phone Number: | 6164945698 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2012 |
| NPI Last Update Date: | 08/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0807X |
| License Number: | 4704212774 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
| Taxonomy Definition: | |