Provider Demographics
NPI:1144231101
Name:WILSON, DAISY (RN)
Entity Type:Individual
Prefix:MS
First Name:DAISY
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C CO 302D BSB ATTN : TMC
Mailing Address - Street 2:UNIT # 15609
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96224-5609
Mailing Address - Country:KR
Mailing Address - Phone:0118231-869-6796
Mailing Address - Fax:0118231-869-6727
Practice Address - Street 1:US ARMY HEALTH CLINIC
Practice Address - Street 2:CAMP CASEY
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96224-0312
Practice Address - Country:KR
Practice Address - Phone:0118231-869-6796
Practice Address - Fax:0118231-869-6727
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC184852163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health