Individual provider · Type 1 NPI
Tiny Benita Wilson, FNP
Family Nurse Practitioner · Conyers, GA
NPI number
1417029133
Active
Practice location
2890 Georgia Highway 212 SW Ste A360
Conyers, GA 30094
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | RN135948NP (GA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1417029133
Tiny Benita Wilson, FNP's National Provider Identifier is 1417029133, issued on Nov 15, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Conyers, GA. The record was last updated on Jun 20, 2018.