Individual
STEPHANIE DIANE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5600 S QUEBEC ST STE 312A, GREENWOOD VILLAGE, CO 80111-2208
(303) 436-2727
Mailing address
2626 COLORADO AVE, DURANGO, CO 81301-4702
(970) 903-2778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0008872
CO
Other
Enumeration date
01/31/2025
Last updated
02/24/2025
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