Individual
DONNA WILKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2034 N 3RD ST, PHOENIX, AZ 85004
(602) 288-0777
(602) 340-0398
Mailing address
2034 N 3RD ST, PHOENIX, AZ 85004
(602) 288-0777
(602) 340-0398
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN056121
AZ
363L00000X
Nurse Practitioner
Primary
NP188
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177479
—
AZ
Enumeration date
03/31/2006
Last updated
06/02/2010
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