Doctor Name: | ERROL WILSON |
NPI Number: | 1760598130 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | RN500867 |
Business Practice Address: | 55557 Campus Road Centro Medico Coachella Thermal, CA - 92274 |
Business Phone Number: | 7603994526 |
Business Fax Number: | 7602626195 |
Mailing Address: | P.o. Box 2369, 4343 Yaqui Pass Road BORREGO SPRINGS |
State: | CA |
Postal Code: | 920042369 |
Phone Number: | 7607675051 |
Fax Number: | 7607674552 |
NPI Enumeration Date: | 08/21/2006 |
NPI Last Update Date: | 01/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WG0000X |
License Number: | RN500867 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | General Practice |
Taxonomy Definition: |