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Individual

AMOS HERR WILKINSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1171 W TARGET RANGE RD, NOGALES, AZ 85621-2415
(520) 285-3000
Mailing address
2202 N FORBES BLVD, TUCSON, AZ 85745-1412
(520) 872-7536
(520) 872-7929

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0397
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104537
AZ
01
Z145141
MEDICARE PTAN
AZ
Enumeration date
06/15/2006
Last updated
01/10/2012
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