Individual
AMANDA MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1151 W IRON SPRINGS RD STE F, PRESCOTT, AZ 86305-1614
(928) 445-8160
Mailing address
5980 S MORNING STAR LN, PRESCOTT, AZ 86303-8668
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10995
AZ
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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