IndividualActive
Carlie Wilson, MSN, PRN, AGCNS-BC
NPI 1013596139 · Gerontology Clinical Nurse Specialist · Livonia, MI
Provider details
- NPI number
- 1013596139
- Entity type
- Individual
- Primary specialty
- Gerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- MSN, PRN, AGCNS-BC
- Sex
- Female
- Sole proprietor
- No
- License
- 2021000750 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
19360 Shadyside St
Livonia, MI 48152-1319
Phone: (734) 678-7186
Approximate (ZIP-level) locationGet directions
Mailing address
19360 Shadyside St
Livonia, MI 48152-1319
Registry dates
- Enumerated
- 2021-04-06
- Last updated
- 2021-04-06
- Certified
- 2021-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.