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Elizabeth L. Wilson, PNP
Pediatric Nurse Practitioner in Tifton, Georgia
NPI 1093080541

Elizabeth L. Wilson is a Pediatric Nurse Practitioner based in Tifton, GA and is specialized in Pediatrics. Elizabeth L. Wilson practices in Tifton, GA and has the professional credentials of PNP. The NPI Number for Elizabeth L. Wilson is 1093080541 and holds a License No. RN191733 (Georgia).

The current practice location address for Elizabeth L. Wilson is 215 12Th St W, Tifton, GA and can be reached out via phone at 229-396-5335 and via fax at 229-396-5330.

Location: 215 12Th St W, Tifton, GA, 31794-3923
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093080541
Provider Name
Elizabeth L. Wilson
Credential
PNP
Provider Entity Type
Individual
Gender
Female
Address
215 12Th St W, Tifton, GA, 31794-3923
Phone Number
229-396-5335
Fax Number
229-396-5330
Provider Enumeration Date
03/16/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
RN191733 01 GA GA MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
215 12Th St W
City
Tifton
State
Georgia
Zip
31794-3923
Phone Number
229-396-5335
Fax Number
229-396-5330
person
Provider Business Mailing Address Details
Address
215 12Th St W
City
Tifton
State
Georgia
Zip
31794-3923
Phone Number
229-396-5335
Fax Number
229-396-5330
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
RN191733 (Georgia)
Definition
Definition to come...
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