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NPI Code Detail

MEDICARE: LAURIE A. WILSON N.P.

MEDICARE:   LAURIE A. WILSON  N.P.
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
1363LA2200XAdult Health Nurse PractitionerAPRN00412RI
2363LA2200XAdult Health Nurse PractitionerCNP164706MA

General Provider Information

NPI Number : 1841226875
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE A. WILSON N.P.
Provider Business Mailing Address
First Line : 311 DORIC AVE
Second Line :
City : CRANSTON
State : RI
Zip : 02910-2903
Country : US
Telephone Number : 401-467-9610
Fax Number : 401-223-0121
Provider Business Practice Location Address
First Line : 1090 CRANSTON ST
Second Line :
City : CRANSTON
State : RI
Zip : 02920-7323
Country : US
Telephone Number : 401-467-9610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 04/30/2023

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Directions to “ LAURIE A. WILSON N.P.” Practice Location

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