| NPI | 1003329111 |
|---|---|
| Former Name | KATHY JEAN WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 0030119) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 22607) |
| 163WF0300X Registered Nurse, Flight (Licence: TN 22607) | |
| 207Q00000X Family Medicine (Licence: VA 0024187761) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187761) | |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2024-07-23 |