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NPI Code Detail

MEDICARE: BARBARA MITCHELL WILSON CRNFA

MEDICARE: BARBARA MITCHELL WILSON CRNFA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WR0006XRegistered Nurse First AssistantR069686GA

General Provider Information

NPI Number : 1013000777
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA MITCHELL WILSON CRNFA
Provider Business Mailing Address
First Line : PO BOX 1415
Second Line :
City : DULUTH
State : GA
Zip : 30096-0025
Country : US
Telephone Number : 770-476-7047
Fax Number : 770-476-5845
Provider Business Practice Location Address
First Line : 3500 MCCLURE BRIDGE RD
Second Line :
City : DULUTH
State : GA
Zip : 30096-3131
Country : US
Telephone Number : 770-476-7047
Fax Number : 770-476-5845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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Directions to “ BARBARA MITCHELL WILSON CRNFA” Practice Location

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