Wilson, Jennifer L.

Wilson, Jennifer L. is an individual health care provider with primary practice located at 200 Southhampton Drive Ste 104, Columbia MO 65203. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Wilson, Jennifer L. can be contacted via phone (573) 499-9009.

Contact Information

Primary practice address
200 Southhampton Drive Ste 104 Columbia MO 65203
Phone: (573) 499-9009
Fax: (573) 499-4400
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 112907 Missouri

Profile Details

NPI number 1932130200
LBN Legal business name Wilson, Jennifer L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Dec 21st, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932130200 NPPES
Missouri MEDICAID 207326300

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