Doctor Name: | KARYN WILSON |
NPI Number: | 1184046740 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | RN139914 |
Business Practice Address: | 100 Gross Crescent Cir Fort Oglethorpe, GA - 307423643 |
Business Phone Number: | 7068582000 |
Business Fax Number: | 7069521489 |
Mailing Address: | 100 Gross Crescent Cir, FORT OGLETHORPE |
State: | GA |
Postal Code: | 307423643 |
Phone Number: | 7068582000 |
Fax Number: | 7069521489 |
NPI Enumeration Date: | 01/15/2014 |
NPI Last Update Date: | 01/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN139914 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |