Individual
JOVITA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 E 10TH ST, TUCSON, AZ 85719-5813
(708) 368-1562
Mailing address
1010 E 10TH ST, TUCSON, AZ 85719-5813
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LP053325
AZ
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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