| NPI | 1578900056 |
|---|---|
| Former Name | AMANDA MICHELLE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: KY 3018470) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner Neonatal (Licence: FL ARNP9353428) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2023-08-08 |