IndividualActive
Holly Wilson, PHYSICIAN ASSISTANT
NPI 1962707182 · Surgical Physician Assistant · Columbia, MO
Provider details
- NPI number
- 1962707182
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PHYSICIAN ASSISTANT
- Sex
- Female
- Sole proprietor
- No
- License
- 0110002870 (VA)
Mailing address
919 Country Ridge Dr
Jefferson City, MO 65109-5738
Registry dates
- Enumerated
- 2011-01-19
- Last updated
- 2011-01-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.