Provider Demographics
NPI:1316527773
Name:WILSON, HOPE ELIZABETH (MPH, RDN)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:ELIZABETH
Last Name:WILSON
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 RODEO DR STE C
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2318
Mailing Address - Country:US
Mailing Address - Phone:928-445-6590
Mailing Address - Fax:
Practice Address - Street 1:840 RODEO DR STE C
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2318
Practice Address - Country:US
Practice Address - Phone:928-445-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator