| NPI | 1245735943 |
|---|---|
| Former Name | JACQUELINE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 0000023945) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 23945) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2020-11-23 |