Provider Demographics
NPI:1588487409
Name:WILSON, VALORIE ANN (RN AND FNP-STUDENT)
Entity type:Individual
Prefix:
First Name:VALORIE
Middle Name:ANN
Last Name:WILSON
Suffix:
Gender:F
Credentials:RN AND FNP-STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 554
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-3010
Mailing Address - Country:US
Mailing Address - Phone:520-827-0133
Mailing Address - Fax:
Practice Address - Street 1:10641 E SINBAD DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-9733
Practice Address - Country:US
Practice Address - Phone:520-827-0133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program