Provider Demographics
NPI:1669548210
Name:WILSON, MARGARET D (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:D
Last Name:WILSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CLEVELAND STREET
Mailing Address - Street 2:SUITE 270
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555
Mailing Address - Country:US
Mailing Address - Phone:931-484-7596
Mailing Address - Fax:931-484-7597
Practice Address - Street 1:49 CLEVELAND ST
Practice Address - Street 2:SUITE 270
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-9716
Practice Address - Country:US
Practice Address - Phone:931-484-7596
Practice Address - Fax:931-484-7597
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3336OtherCERTIFICATE OF FITNESS