Vicki Wilson
Registered Nurse in Tyler, TX. Individual provider (NPI-1).
NPI number1114519782
StatusActive
Last updated in NPPESFeb 5, 2021
Details
- NPI
- 1114519782
- Entity type
- Individual (NPI-1)
- Name
- Vicki Wilson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 5, 2021
- Certification date
- Feb 5, 2021
- Last updated
- Feb 5, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 505283 | TX | Yes |
Practice location
9846 Hwy 31 ETyler, TX 75705-2329
Phone 903-592-8001
Mailing address
9846 Hwy 31 ETyler, TX 75705-2329
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