| Doctor Name: | CAROLE L. WILLSON |
| NPI Number: | 1346473030 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP010401 |
| Business Practice Address: | 503 Sunset Dr Olyphant, PA - 184471323 |
| Business Phone Number: | 5703427864 |
| Business Fax Number: | |
| Mailing Address: | 225 Penn Ave, SCRANTON |
| State: | PA |
| Postal Code: | 185031921 |
| Phone Number: | 5703427864 |
| Fax Number: | 5702077678 |
| NPI Enumeration Date: | 08/27/2009 |
| NPI Last Update Date: | 12/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP010401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |