Individual
NANCY JANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
943 HUALAPAI WAY, PEACH SPRINGS, AZ 86434
(928) 769-2900
Mailing address
930 HUALAPAI WAY, PEACH SPRINGS, AZ 86434
(928) 769-1168
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
7218
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2088324
—
OH
Enumeration date
01/30/2007
Last updated
03/12/2012
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