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1134871007
DENISA BROOME WILSON
RICHLAND, MS
NPI
1134871007
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS 905068)
Enumeration Date
2022-01-21
Last Update Date
2022-05-19
Business Address
DENISA BROOME WILSON FNP-C
907 US 49
RICHLAND, MS 39218
Phone number: 601-374-5263
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Mailing Address
DENISA BROOME WILSON FNP-C
PO BOX 490
UTICA, MS 39175-0490
Phone number:
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