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NPI Code Detail

MEDICARE: HEIDI EILEEN WILSON MSN, ANP-C

MEDICARE: HEIDI EILEEN WILSON MSN, ANP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerAP1753AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962577403
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI EILEEN WILSON MSN, ANP-C
Provider Business Mailing Address
First Line : 6296 E GRANT RD STE 140
Second Line :
City : TUCSON
State : AZ
Zip : 85712-5876
Country : US
Telephone Number : 520-298-3321
Fax Number : 702-804-3655
Provider Business Practice Location Address
First Line : 6296 E GRANT RD STE 140
Second Line :
City : TUCSON
State : AZ
Zip : 85712-5876
Country : US
Telephone Number : 520-298-3321
Fax Number : 888-978-2518
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 12/16/2019

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