Individual
MRS. JEANIE M WILDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AZAP1131
AZ
363LP2300X
Primary Care Nurse Practitioner
Primary
AP1131
AZ
Other
Enumeration date
12/11/2006
Last updated
04/25/2024
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