Individual
IVEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1273 E HAMPTON LN, GILBERT, AZ 85295-6159
(480) 466-1239
Mailing address
1273 E HAMPTON LN, GILBERT, AZ 85295-6159
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN158553
AZ
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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