Individual
MONICA ASHLEY WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 N VAN BUREN ST, ENID, OK 73703-2524
(580) 297-9993
Mailing address
1001 W MEMORIAL RD STE 112, OKLAHOMA CITY, OK 73114-2000
(405) 509-6599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
117508
OK
363LF0000X
Family Nurse Practitioner
Primary
117508
OK
363LF0000X
Family Nurse Practitioner
53-79398-032
KS
Other
Enumeration date
08/22/2019
Last updated
02/22/2023
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