Healthcare Provider Details
I. General information
NPI: 1497626006
Provider Name (Legal Business Name): WILSON HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/16/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
605 W GOVERNMENT ST
BRANDON MS
39042-3153
US
IV. Provider business mailing address
PO BOX 1465
BRANDON MS
39043-1465
US
V. Phone/Fax
- Phone: 601-260-0314
- Fax:
- Phone: 601-825-2696
- Fax: 601-825-2463
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MARGO
WILSON
GARRETT
Title or Position: OWNER
Credential: FNP
Phone: 601-502-3574