Individual
SHASTYN BREE WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-AG
Contact information
Practice address
18444 N 25TH AVE STE 210, PHOENIX, AZ 85023-1264
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
280299
AZ
Other
Enumeration date
10/19/2022
Last updated
01/12/2023
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