person
Mrs. Laura Renae Wilson, MSN,APRN-BC
Primary Care Nurse Practitioner in Stone Mountain, Georgia
NPI 1104032218

Laura Renae Wilson is a Primary Care Nurse Practitioner based in Stone Mountain, GA and is specialized in Primary Care. Laura Renae Wilson practices in Stone Mountain, GA and has the professional credentials of MSN,APRN-BC. The NPI Number for Laura Renae Wilson is 1104032218 and holds a License No. 004365 (Georgia).

The current practice location address for Laura Renae Wilson is 5405 Memorial Dr Ste D, Stone Mountain, GA and can be reached out via phone at 404-296-3800 and via fax at 404-297-8753.

Location: 5405 Memorial Dr Ste D, Stone Mountain, GA, 30083-3236
person
Provider Profile Details
NPI Number
1104032218
Provider Name
Laura Renae Wilson
Credential
MSN,APRN-BC
Provider Entity Type
Individual
Gender
Female
Address
5405 Memorial Dr Ste D, Stone Mountain, GA, 30083-3236
Phone Number
404-296-3800
Fax Number
404-297-8753
Provider Enumeration Date
05/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1821185299 01 TX NPI - BVCAA
1275620551 01 TX NPI - ROBERTSON COUNTY CHC
154467803 05 TX
1649265646 01 TX NPI- BRYAN- COLLEGE STATION CHC
institution
Provider Business Practice Location Address Details
Address
5405 Memorial Dr Ste D
City
State
Zip
30083-3236
Phone Number
404-296-3800
Fax Number
404-297-8753
person
Provider Business Mailing Address Details
Address
5405 Memorial Dr Ste D
City
State
Zip
30083-3236
Phone Number
404-296-3800
Fax Number
404-297-8753
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
701633 (Texas)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
004365 (Connecticut)
Definition
Definition to come...
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