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Logan Blaze Wilson, FNP-C
Family Nurse Practitioner in Plano, Texas
NPI 1124678305

Logan Blaze Wilson is a Family Nurse Practitioner based in Plano, TX and is specialized in Family. Logan Blaze Wilson practices in Plano, TX and has the professional credentials of FNP-C. The NPI Number for Logan Blaze Wilson is 1124678305 and holds a License No. AP143063 (Texas).

The current practice location address for Logan Blaze Wilson is 6529 W Plano Pkwy Ste D, Plano, TX and can be reached out via phone at 972-781-1414.

Location: 6529 W Plano Pkwy Ste D, Plano, TX, 75093-8262
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124678305
Provider Name
Logan Blaze Wilson
Credential
FNP-C
Provider Entity Type
Individual
Gender
Female
Address
6529 W Plano Pkwy Ste D, Plano, TX, 75093-8262
Phone Number
972-781-1414
Fax Number
Provider Enumeration Date
09/18/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PENDING 01 TX BCBSTX
PENDING 05 TX
institution
Provider Business Practice Location Address Details
Address
6529 W Plano Pkwy Ste D
City
Plano
State
Texas
Zip
75093-8262
Phone Number
972-781-1414
Fax Number
person
Provider Business Mailing Address Details
Address
6529 W Plano Pkwy Ste D
City
Plano
State
Texas
Zip
75093-8262
Phone Number
972-781-1414
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
AP143063 (Texas)
Definition
Definition to come...
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