Provider Demographics
NPI:1194169102
Name:WILSON-NATAL, PEARLIE (FNP)
Entity type:Individual
Prefix:
First Name:PEARLIE
Middle Name:
Last Name:WILSON-NATAL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 S CORONADO DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-6354
Mailing Address - Country:US
Mailing Address - Phone:520-439-0115
Mailing Address - Fax:
Practice Address - Street 1:100 E 5TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-2859
Practice Address - Country:US
Practice Address - Phone:520-364-7659
Practice Address - Fax:520-364-8541
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-20
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily