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Patricia Ann Wilson, CNIM
Electroneurodiagnostic Specialist/Technologist in Pocatello, Idaho
NPI 1508232604

Patricia Ann Wilson is a Electroneurodiagnostic Specialist/Technologist based in Pocatello, ID and is specialized in Electroneurodiagnostic. Patricia Ann Wilson practices in Pocatello, ID and has the professional credentials of CNIM. The NPI Number for Patricia Ann Wilson is 1508232604 and holds a License No. 713 (Idaho).

The current practice location address for Patricia Ann Wilson is 1019 Sagewood Pl, Pocatello, ID and can be reached out via phone at 208-221-0234.

Location: 1019 Sagewood Pl, Pocatello, ID, 83201-2729
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508232604
Provider Name
Patricia Ann Wilson
Credential
CNIM
Provider Entity Type
Individual
Gender
Female
Address
1019 Sagewood Pl, Pocatello, ID, 83201-2729
Phone Number
208-221-0234
Fax Number
Provider Enumeration Date
08/12/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
713 01 CNIM
institution
Provider Business Practice Location Address Details
Address
1019 Sagewood Pl
City
Pocatello
State
Idaho
Zip
83201-2729
Phone Number
208-221-0234
Fax Number
person
Provider Business Mailing Address Details
Address
1019 Sagewood Pl
City
Pocatello
State
Idaho
Zip
83201-2729
Phone Number
208-221-0234
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist, Other
Speciality
Electroneurodiagnostic
Taxonomy
246ZE0600X
License No.
713 ()
Definition
Definition to come...
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