Tanya Wilson
Individual provider Active NPI Homemaker · Phoenix, AZ
NPI 1093508293 · NPPES record last updated May 28, 2025
Key facts
- NPI
- 1093508293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- Practice address
- 4233 S 58TH Dr
Phoenix, AZ 85043-6414 - Phone
- (480) 389-7983
- NPI assigned
- May 28, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Yes |
Addresses
Primary practice location
4233 S 58TH Dr
Phoenix, AZ 85043-6414
Mailing address
4233 S 58TH Dr
Phoenix, AZ 85043-6414
Phone (480) 389-7983
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2025. 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.