| Mary Wilson, | |
|
704 W Historic Rt. 66, Waynesville, MO 65583 | |
| (573) 774-3121 | |
| (573) 774-2235 |
| Full Name | Mary Wilson |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 704 W Historic Rt. 66, Waynesville, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336689439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 2002021037 (Missouri) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Wilson, 704 W Historic Rt. 66, Waynesville, MO 65459 Ph: (573) 774-3121 | Mary Wilson, 704 W Historic Rt. 66, Waynesville, MO 65583 Ph: (573) 774-3121 |
Johnna Pitts, 2017002215 Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 704 Route 66 W Ste 200, Waynesville, MO 65583 Phone: 573-774-3121 Fax: 573-744-2235 | |
Nathasia Dorsey, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 20970 Lynwood Rd, Waynesville, MO 65583 Phone: 573-596-0131 |