| Doctor Name: | LOIS ANN WILSON |
| NPI Number: | 1154599173 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 55258 |
| Business Practice Address: | 3225 Independence Rd Canon City, CO - 812129380 |
| Business Phone Number: | 7192752351 |
| Business Fax Number: | 7192699386 |
| Mailing Address: | 3225 Independence Rd, CANON CITY |
| State: | CO |
| Postal Code: | 812129380 |
| Phone Number: | 7192752351 |
| Fax Number: | 7192699386 |
| NPI Enumeration Date: | 02/12/2008 |
| NPI Last Update Date: | 02/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 55258 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |