Individual
KATHRYN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5201 N 19TH AVE, SUITE 121, PHOENIX, AZ 85015-2951
(602) 433-1882
Mailing address
5201 N 19TH AVE, SUITE 121, PHOENIX, AZ 85015-2951
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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