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General NPI Number Information
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NPI Number | 1205743416
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Entity Type | Individual
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Provider Name | CRISTINA WILSON RN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 5212 HOLY CROSS PARKWAY
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City | MISHAWAKA
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State | IN
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Zip | 46545
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Country | US
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Telephone | 574-335-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 11228 BRIDLEWOOD TRL
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49103-9649
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Country | US
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Telephone | 630-518-8526
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Fax |
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 23625344
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License Number State | IN
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