Chantal Tanisha Marie Wilson
NPI #1023442407 in Orange, New Jersey
Provider Information
- NPI Number
- 1023442407
- Entity Type
- Individual
- Name
- Chantal Tanisha Marie Wilson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Registered Nurse
- Enumeration Date
- Aug 21, 2013
- Last Updated
- Aug 21, 2013
Practice Location
- Address
- 765 VOSE AVE
- Address 2
- APT B10
- City
- Orange
- State
- New Jersey
- ZIP Code
- 07050-1060
- Phone
- (973) 943-3728
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse |
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