Provider Demographics
NPI:1699731638
Name:WILSON, NANCY PRATT (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:PRATT
Last Name:WILSON
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:2585 HORSHAM DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38139-6665
Mailing Address - Country:US
Mailing Address - Phone:901-759-5908
Mailing Address - Fax:901-759-5908
Practice Address - Street 1:314TH MEDICAL OPERATIONS SQUADRON 1090 ARNOLD DRIV
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK AFB
Practice Address - State:AR
Practice Address - Zip Code:72099-0001
Practice Address - Country:US
Practice Address - Phone:501-987-7234
Practice Address - Fax:501-987-7216
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TNRN0000134308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily