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General NPI Number Information
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NPI Number | 1245463645
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Entity Type | Individual
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Provider Name | MS. NANCY LEE WILSON
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Gender | Female
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 3333 SCENIC HWY
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City | PENSACOLA
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State | FL
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Zip | 32503-5143
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Country | US
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Telephone | 850-470-0146
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 SCENIC HWY
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City | PENSACOLA
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State | FL
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Zip | 32503-5143
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Country | US
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Telephone | 850-470-0146
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 004622
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS23357
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07692
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License Number State | MS
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