Most Relevant Information
Provider Data
| NPI Number: | 1003337395 |
| Provider Name: | SHAKIA WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 326942 |
Most Important Dates
| Enumeration Date: | 06/28/2017 |
| Last Updated: | 06/28/2017 |
Provider Practice Location
114 GREEN KNOLLS DR APT C
ROCHESTER
NY
146204840
Practice Location Phone/Fax
| Phone: | 5858205072 |
| Fax: |
Provider Mailing Location
114 GREEN KNOLLS DR APT C
ROCHESTER
NY
146204840
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |