Provider Demographics
NPI:1336272251
Name:WILLSON, KARI LYN (CFNP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYN
Last Name:WILLSON
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
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Mailing Address - Street 1:333 MAGAZINE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1867
Mailing Address - Country:US
Mailing Address - Phone:906-253-9770
Mailing Address - Fax:906-253-9772
Practice Address - Street 1:550 OSBORN BLVD
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1899
Practice Address - Country:US
Practice Address - Phone:906-632-0370
Practice Address - Fax:906-632-6373
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2010-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL28663972363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP28663972OtherFLORIDA LICENSE
MIMI 4704196937OtherMICHIGAN NURSE PRACTITIONER LICENSURE