E Joan Wilson, CLS
Individual provider Active NPI Medical Illustrator · Dulce, NM
NPI 1043479330 · NPPES record last updated Jun 4, 2008
Key facts
- NPI
- 1043479330
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Illustrator 246ZI1000X
- License
- 9905528 (KS)
- Practice address
- 12000 Stone Lake Road
Dulce, NM 87528 - Phone
- (505) 759-7238
- NPI assigned
- Jun 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9905528 | KS | MD | Medical Illustrator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Illustrator | 246ZI1000X | 9905528 | KS | Yes |
Addresses
Primary practice location
12000 Stone Lake Road
Dulce, NM 87528
Mailing address
PO Box 1403
Ocean Park, WA 98640
Phone (360) 665-4599
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000K3526 | Medicaid | NM | |
| HSZ196 | Other | NM | MEDICARE PART B |
Other providers in Dulce, NM
- Susan Ann Velarde
- Inna Voinich
- Nancy Jane Watts
- Mitchell R. Wilkinson
- Kristine S Williams
- Stella Elizabeth Wilson
- David Zuflacht
All providers in Dulce, NM · Medical Illustrator in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.