Wilson, Gena R

Wilson, Gena R is an individual health care provider with primary practice located at 1920 E Cambridge Ave Ste 304 , Phoenix AZ 85006. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Wilson, Gena R can be contacted via phone (602) 933-4363.

Contact Information

Primary practice address
1920 E Cambridge Ave Ste 304 Phoenix AZ 85006
Phone: (602) 933-4363
Fax: (602) 933-2415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN060806 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP6776 Arizona

Profile Details

NPI number 1861453490
LBN Legal business name Wilson, Gena R
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Jul 25th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861453490 NPPES
Arizona MEDICAID 863177

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