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1417029133
TINY BENITA WILSON
CONYERS, GA
NPI
1417029133
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN135948NP)
Enumeration Date
2006-11-15
Last Update Date
2018-06-20
Business Address
Ms. TINY BENITA WILSON FNP
2890 GEORGIA HIGHWAY 212 SW STE A360
CONYERS, GA 30094
Phone number: 770-601-6892
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Mailing Address
Ms. TINY BENITA WILSON FNP
2890 GEORGIA HIGHWAY 212 SW STE A360
CONYERS, GA 30094-3363
Phone number: 770-601-6892
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