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General NPI Number Information
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NPI Number | 1073334975
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Entity Type | Individual
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Provider Name | TERRIE S WILSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 301 HOSPITAL BLVD COLLINS
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City | COLLINS
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State | MS
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Zip | 39428
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Country | US
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Telephone | 601-698-0328
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Fax | 601-765-2808
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Provider Business Mailing Address
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Address Line | PO BOX 2499
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City | COLLINS
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State | MS
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Zip | 39428-2499
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Country | US
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Telephone | 601-765-6711
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Fax | 601-698-0112
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 906643
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License Number State | MS
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