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1225687791
JACQUELINE LATIA WILSON
LOUISVILLE, KY
NPI
1225687791
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: KY 3013705)
Enumeration Date
2019-09-08
Last Update Date
2020-03-13
Business Address
Ms. JACQUELINE LATIA WILSON FNP-C
225 N CLIFTON AVE
LOUISVILLE, KY 40206-2496
Phone number: 502-794-3894
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Mailing Address
Ms. JACQUELINE LATIA WILSON FNP-C
225 N CLIFTON AVE
LOUISVILLE, KY 40206-2496
Phone number: 502-794-3894
Copy
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