| NPI | 1376823310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY W WILSON Owner/Family Nurse Practitioner 910-208-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 201012) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |