Wilson, Tasha Marie

Wilson, Tasha Marie is an individual health care provider with primary practice located at 1145 Sturgis Rd , Twentynine Palms CA 92278. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wilson, Tasha Marie can be contacted via phone (760) 830-2190.

Contact Information

Primary practice address
1145 Sturgis Rd Twentynine Palms CA 92278
Phone: (760) 830-2190
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN11007850 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP95028514 California

Profile Details

NPI number 1396341459
LBN Legal business name Wilson, Tasha Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2020
Last updated May 13th, 2025 - about last year

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 1396341459 NPPES
Other 1110098576 DOD

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