Individual
JANE N WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4212 N 16TH ST, OB/GYN DEPARTMENT, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1692
Mailing address
1217 N MILLER RD, UNIT 34, SCOTTSDALE, AZ 85257-3659
(480) 656-3390
(602) 263-1692
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN079372
AZ
367A00000X
Advanced Practice Midwife
Primary
153
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440941
—
AZ
Enumeration date
06/23/2006
Last updated
08/04/2011
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