Wilson, Susan Diane

Wilson, Susan Diane is an individual health care provider with primary practice located at 126 Missouri Ave Mcxp-Ccs-Cr, Fort Leonard Wood MO 65473-8952. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wilson, Susan Diane can be contacted via phone (573) 596-0417.

Contact Information

Primary practice address
126 Missouri Ave Mcxp-Ccs-Cr Fort Leonard Wood MO 65473-8952
Phone: (573) 596-0417
Fax: (573) 596-0524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2002021223 Missouri

Profile Details

NPI number 1568552487
LBN Legal business name Wilson, Susan Diane
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jul 8th, 2007 - about 18 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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