Provider Demographics
NPI:1972226587
Name:CONCIO, WILFREDO ALBERTO (FNP-C)
Entity Type:Individual
Prefix:
First Name:WILFREDO
Middle Name:ALBERTO
Last Name:CONCIO
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 E BROADWAY RD STE 116
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1685
Mailing Address - Country:US
Mailing Address - Phone:480-499-0102
Mailing Address - Fax:480-499-0295
Practice Address - Street 1:1845 E BROADWAY RD STE 116
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1685
Practice Address - Country:US
Practice Address - Phone:480-499-0102
Practice Address - Fax:480-499-0295
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ281115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily