LISA NICOLE WILSON

PORT JEFFERSON, NY
NPI1942182472
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: NY  F312374-01)
Enumeration Date2025-07-24
Last Update Date2025-07-24
Business Address
LISA NICOLE WILSON NP
640 BELLE TERRE RD
PORT JEFFERSON, NY 11777-1936
Phone number: 631-828-5361
Mailing Address
LISA NICOLE WILSON NP
195 N UTICA AVE
NORTH MASSAPEQUA, NY 11758-2143
Phone number: 347-423-1784
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