Provider Demographics
NPI:1447450861
Name:WILSON, MARKEY DONNELL (MHS, PA-C)
Entity type:Individual
Prefix:MS
First Name:MARKEY
Middle Name:DONNELL
Last Name:WILSON
Suffix:
Gender:F
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6070 S FORT APACHE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5615
Mailing Address - Country:US
Mailing Address - Phone:702-307-7700
Mailing Address - Fax:702-307-7942
Practice Address - Street 1:6070 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5615
Practice Address - Country:US
Practice Address - Phone:702-307-7700
Practice Address - Fax:702-307-7942
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA792363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant