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General NPI Number Information
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NPI Number | 1811212830
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Entity Type | Individual
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Provider Name | DEBORAH CHAMPLIN WILSON ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/01/2010
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 7541 BUCCANEER AVE
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City | NORTH BAY VILLAGE
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State | FL
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Zip | 33141-4111
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Country | US
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Telephone | 305-332-5243
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Fax |
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Provider Business Mailing Address
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Address Line | 7541 BUCCANEER AVE
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City | NORTH BAY VILLAGE
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State | FL
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Zip | 33141-4111
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Country | US
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Telephone | 305-332-5243
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 872762
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License Number State | FL
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