Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA WILSON, RN
Active Sole ProprietorNutrition Support Nurse · FAYETTEVILLE, AR
Registration Details
- NPI Number
- 1962246207
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 21, 2024 (1.8740642621782 yrs)
- Last Updated
- Jun 21, 2024
- License
-
R090453 (AR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
229 N BLOCK AVEFAYETTEVILLE, AR, 727015204Browse AR providers · Browse ZIP 72701
- Phone
- 4792002749
- Primary Specialty
-
Nutrition Support Nurse
163WN1003X
- Additional Specialty
- Nutrition Support Nurse
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.