Provider Demographics
NPI:1013452309
Name:SOMERA, WILHELMINA C (RN-BC,CCRN,MSN FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:WILHELMINA
Middle Name:C
Last Name:SOMERA
Suffix:
Gender:F
Credentials:RN-BC,CCRN,MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6617 S QUAIL VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-8681
Mailing Address - Country:US
Mailing Address - Phone:520-731-1047
Mailing Address - Fax:
Practice Address - Street 1:6617 S QUAIL VISTA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-8681
Practice Address - Country:US
Practice Address - Phone:520-731-1047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9658363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care