Provider Demographics
NPI:1255470811
Name:WILSON, MARGARET RUTH (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:RUTH
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 1:658 MACKEY RD
Mailing Address - Street 2:
Mailing Address - City:SNEEDVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37869-4429
Mailing Address - Country:US
Mailing Address - Phone:423-733-2343
Mailing Address - Fax:
Practice Address - Street 1:178 WILLOW STREET
Practice Address - Street 2:
Practice Address - City:SNEEDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37869
Practice Address - Country:US
Practice Address - Phone:423-733-2228
Practice Address - Fax:423-733-2428
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000100626163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse