Healthcare Provider Details

I. General information

NPI: 1609512979
Provider Name (Legal Business Name): DR. BRITNEY N. WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 BETHLEHEM PIKE STE 210
FLOURTOWN PA
19031-1919
US

IV. Provider business mailing address

151 SOUTHHALL LN STE 300
MAITLAND FL
32751-7172
US

V. Phone/Fax

Practice location:
  • Phone: 215-254-7070
  • Fax: 215-254-7079
Mailing address:
  • Phone: 908-296-5727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD497292
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: