Individual
DIANNE POLONUS WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.F.A.
Contact information
Practice address
986 PALMER AVE, CAMARILLO, CA 93010-4636
(805) 445-1276
Mailing address
986 PALMER AVE, CAMARILLO, CA 93010-4636
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
453366
CA
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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