Individual
RACHEAL L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
975 RYLAND ST STE 100, RENO, NV 89502-1669
(775) 982-5000
(775) 982-5225
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1365
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14352693
CAQH
NV
01
—
PA1365
NEVADA STATE BOARD OF MEDICAL EXAMINERS
NV
Enumeration date
07/30/2012
Last updated
11/20/2019
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