Individual
MRS. BARBARA ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2155 E LIBERTY LN APT 121, PHOENIX, AZ 85048-8129
(480) 469-4376
Mailing address
2155 E LIBERTY LN APT 121, PHOENIX, AZ 85048-8129
(480) 469-4376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN071839
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A77800205
AHCCCS ID# MERCY CARE
AZ
Enumeration date
06/15/2015
Last updated
10/07/2022
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