| NPI | 1629260112 |
|---|---|
| Former Name | PEGGY SUZANNE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30001789) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GU RN20R32) |
| 363LF0000X Nurse Practitioner, Family (Licence: GU 20R32-20NP01) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP229A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GU APRN20NP) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2023-02-22 |