Azure Marie Wilson, BSN, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

612407 Issued in CA

Practice address

13984 Blue Ribbon LN
Eastvale, CA 92880-3035

Phone

(951) 256-0902

NPI assigned

Jan 21, 2021

Last updated

Jan 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1780274068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13984 BLUE RIBBON LN",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803035",
            "telephone_number": "951-256-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13984 BLUE RIBBON LN",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803035",
            "telephone_number": "951-256-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AZURE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "612407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Olivia Washington, M.D.
• Grace Nyambura Weru
• Dion Whitehead, NP
• Jonathan M Williams
• Natalie Williams
• Danica Wong, LCSW
• Wing Kwan Wong, FNP-BC
• Marissa Worth, PSY.D.
• Beth Wright
• Olivia Anne Yance, RN,FNP-C

• Registered Nurse in Eastvale, CA
• Providers in Eastvale, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.