Provider Demographics
NPI:1033355383
Name:WILK, ZOFIA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ZOFIA
Middle Name:
Last Name:WILK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ZOFIA
Other - Middle Name:
Other - Last Name:MALISZEWSKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:13945 W GRAND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2437
Mailing Address - Country:US
Mailing Address - Phone:623-546-0007
Mailing Address - Fax:
Practice Address - Street 1:13945 W GRAND AVE STE 105
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2437
Practice Address - Country:US
Practice Address - Phone:623-546-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2016-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily