David Lee Wilson Jr.
Nurse Practitioner, Family in Sacramento, CA. Individual provider (NPI-1).
NPI number1467053371
StatusActive
Last updated in NPPESNov 7, 2020
Details
- NPI
- 1467053371
- Entity type
- Individual (NPI-1)
- Name
- David Lee Wilson Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 6, 2020
- Certification date
- Nov 7, 2020
- Last updated
- Nov 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 95014950 | CA | Yes |
Practice location
2315 Stockton BlvdSacramento, CA 95817-2201
Phone 916-734-5590
Mailing address
884 Spotted Pony CtRocklin, CA 95765-5468
Phone 707-590-6358
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