Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | COA.18728-NP | OH |
NPI | 1003278987 |
---|---|
Provider Name | Mrs. Allison Paige Wilson |
First Address | Columbus, OH 43219-3389 |
Second Address | Columbus, OH 43219-3389 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 16/03/2021 |