Individual
MATTHEW JARED WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1850 N CENTRAL AVE STE 1600, PHOENIX, AZ 85004-4633
(602) 528-6996
Mailing address
1850 N CENTRAL AVE STE 1600, PHOENIX, AZ 85004-4633
(602) 528-6996
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN148707
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN148707
RN LICENSE
AZ
Enumeration date
09/13/2017
Last updated
07/21/2022
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