Individual
JAMIE C WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
Mailing address
PO BOX 45538, PHOENIX, AZ 85064-5538
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
204633
AZ
163WM0705X
Medical-Surgical Registered Nurse
204633
AZ
163WW0101X
Ambulatory Women's Health Care Registered Nurse
204633
AZ
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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