Provider Demographics
NPI:1376707406
Name:WILES, BARBARA G (FNP-BC, MSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:G
Last Name:WILES
Suffix:
Gender:F
Credentials:FNP-BC, MSN, RN
Other - Prefix:MRS
Other - First Name:BOBBIE
Other - Middle Name:
Other - Last Name:WILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC, MSN, RN
Mailing Address - Street 1:14780 W MOUNTAIN VIEW BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7280
Mailing Address - Country:US
Mailing Address - Phone:623-374-7774
Mailing Address - Fax:855-420-6361
Practice Address - Street 1:6116 EAST ARBOR AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-641-5400
Practice Address - Fax:480-218-4353
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ370570Medicaid
AZ370570Medicaid