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General NPI Number Information
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NPI Number | 1477588432
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Entity Type | Individual
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Provider Name | JENNIFER M WILSON MD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 235 W 6TH ST
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City | RENO
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State | NV
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Zip | 89503-4548
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Country | US
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Telephone | 775-770-3188
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Fax | 775-770-3588
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Provider Business Mailing Address
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Address Line | PO BOX 21418
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City | RENO
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State | NV
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Zip | 89515-1418
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Country | US
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Telephone | 775-746-3202
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Fax | 775-770-3588
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 10019
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License Number State | NV
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