MS. ROXANNE MILES WILSON


Address: 5140 Yolanda Ave, Tarzana, CA 91356-4027
Phone: 8183448646

MS. ROXANNE MILES WILSON (NPI# 1427337559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427337559
Entity Type Individual
Full Name MS. ROXANNE MILES WILSON
Credential MN,FNP/GNP,DSD,PHN,C
Practice Address 5140 Yolanda Ave
Tarzana
CA 91356-4027
Practice Telephone 8183448646
Mailing Telephone 8183448646
Enumeration Date 2011-08-07
Last Update Date 2018-04-23
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LF0000X Nurse Practitioner
Specialization: Family
RN362861 CA Physician Assistants & Advanced Practice Nursing Providers
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
6708 CA Physician Assistants & Advanced Practice Nursing Providers
N 363LG0600X Nurse Practitioner
Specialization: Gerontology
RN362861 CA Physician Assistants & Advanced Practice Nursing Providers

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Office Location

Street Address 5140 YOLANDA AVE
City TARZANA
State CA
Zip Code 91356-4027

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City TARZANA
Zip Code 91356

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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