| Doctor Name: | MRS. BEVERLY BELK WILSON |
| NPI Number: | 1376908194 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 20005 |
| Business Practice Address: | 10100 S Main St Archdale, NC - 272633134 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | 4016529787 |
| Mailing Address: | Po Box 1872, MOUNT JULIET |
| State: | TN |
| Postal Code: | 371211872 |
| Phone Number: | 6155856699 |
| Fax Number: | |
| NPI Enumeration Date: | 12/21/2015 |
| NPI Last Update Date: | 02/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 20005 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |