Individual
MARY ANN WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, MSN, C-APN
Contact information
Practice address
620 SHADOW LN, LAS VEGAS, NV 89106-4119
(702) 671-8525
Mailing address
13011 E ASPEN BLUFF LN, SPOKANE, WA 99217-9809
(509) 892-9399
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
APN000572
NV
363LN0000X
Neonatal Nurse Practitioner
Primary
APN000572
NV
Other
Enumeration date
04/13/2006
Last updated
03/21/2012
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