Provider Demographics
NPI:1932434073
Name:WILSON, CAROL (FNPC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N THOMPSON LN
Mailing Address - Street 2:STE 1A
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-4339
Mailing Address - Country:US
Mailing Address - Phone:615-494-4800
Mailing Address - Fax:615-494-4801
Practice Address - Street 1:820 N THOMPSON LN
Practice Address - Street 2:STE 1A
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4339
Practice Address - Country:US
Practice Address - Phone:615-494-4800
Practice Address - Fax:615-494-4801
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily