MR. STACY WILSON (NPI# 1194215244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194215244 |
| Entity Type | Individual |
| Full Name | MR. STACY WILSON |
| Credential | RN |
| Practice Address |
1601 Ulupuni St Kailua HI 96734-4452 |
| Mailing Address |
1872 Galleon St North Bay Village FL 33141-4330 |
| Practice Telephone | 8089796875 |
| Mailing Telephone | 3054973745 |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2020-08-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
RN9431499 | FL | Nursing Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APRN-2822 | HI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APRN9431499 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992261085 | Stacy Natasha Wilson | Counselor | 145 Parker Fishery Rd, Winton, NC 27986-9763 | 2019-02-14 |
| 1396276747 | Stacy Wilson | Specialist | 189 Lake St, Oceanside, NY 11572-4212 | 2017-03-27 |
| 1174898365 | Stacy Wilson | Rehabilitation Practitioner | 4233 Pelican Dr, Fallon, NV 89406-2445 | 2012-03-20 |
| 1114236346 | Stacy Allieou Wilson | Occupational Therapist | 4920 Raeford Rd, Fayetteville, NC 28304-3142 | 2010-10-06 |
| 1386277150 | Stacy Ann Wilson | Peer Specialist | 2901 E Burnside St, Portland, OR 97214-1831 | 2020-02-19 |
| 1952862963 | Stacy Wilson | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Msag407p, Temple, TX 76508-0001 | 2019-03-31 |
| 1326507815 | Stacy Wilson | Social Worker | 52 Woodstream Dr, Grand Island, NY 14072 | 2019-03-14 |
| 1881103885 | Stacy J Wilson | Occupational Therapy Assistant | 3355 E Semoran Blvd, Apopka, FL 32703-6062 | 2017-09-22 |
| 1386162436 | Stacy Caye Wilson | Counselor | 505 Coates St, Parkersburg, IA 50665-7733 | 2017-09-08 |
| 1194276584 | Stacy Marie Wilson | Licensed Practical Nurse | 127 East State Street, Gloversville, NY 12078-1204 | 2016-10-20 |
| Street Address |
1601 ULUPUNI ST |
| City | KAILUA |
| State | HI |
| Zip Code | 96734-4452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828773 | About Face Kailua, LLC | General Practice | 970 N. Kalahea Ave, Suite A-11, Kailua, HI 96734 | 2020-10-15 |
| 1134726979 | Sara Eller | Radiology | Building 6905 Mcbh, Pearl Harbor, HI 96734 | 2020-10-05 |
| 1205441888 | William Andrew Fitzpatrick | Military Health Care Provider | Bldg 6905, Mcbh, HI 96734 | 2020-09-10 |
| 1215549670 | Joseph Frabotta | Military Health Care Provider | 6894r Mokapu Rd, Kailua, HI 96734 | 2020-08-18 |
| 1437776366 | Amanda Lindsay Krasniewski | Behavior Technician | 203 Kapaa Quarry Place, Suite #5002, Kailua, HI 96734 | 2020-06-26 |
| 1760007108 | Yoli Gabrielle Teran | Behavior Technician | 203 Kapaa Quarry Pi #5002, Kailua, HI 96734 | 2020-06-11 |
| 1902427206 | Amberlie Remily | Behavior Technician | 203 Kapaa Quarry Pl. #5002, Kailua, HI 96734 | 2020-04-28 |
| 1417586264 | Jennifer Eng | Marriage & Family Therapist | 6842 Harris Ave, Kailua, HI 96734 | 2020-04-03 |
| 1023644523 | Roxan Mae Sardido Okamoto | Specialist | 1178 Lunahana Place, Kailua, HI 96734 | 2020-03-16 |
| 1811520240 | Sherly Macion | Registered Nurse | 720 A1 Kihapai Place, Kailua, HI 96734 | 2020-02-13 |
| Find all providers in zip 96734 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538777537 | Tawni Cook | Nurse Practitioner | 30 Aulike St, Kailua, HI 96734-2739 | 2020-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227005 | Tam Tran | Nurse Practitioner | 1441 Kapiolani Blvd Ste 1902, Honolulu, HI 96814-4409 | 2020-05-22 |
| 1235773011 | Rozlynn Kehaulani Dela Pina | Nurse Practitioner | 91-1021 Kaihi St, Ewa Beach, HI 96706-6223 | 2019-11-04 |
| 1730743956 | Bryan A Johnson | Nurse Practitioner | 94-1221 Ka Uka Blvd # 108-166, Waipahu, HI 96797-6202 | 2019-04-23 |
| 1083163380 | Shelby L Wilcox | Nurse Practitioner | 98-1079 Moanalua Rd Ste 300, Aiea, HI 96701-4722 | 2016-09-27 |
| 1598008849 | Victoria Dennis | Nurse Practitioner | 691 Mopua St, Haiku, HI 96708-5629 | 2013-04-04 |
| 1326384819 | Rolin Yoshiaki Kuba | Nurse Practitioner | 1717 Mott-smith Dr Apt 2611, Honolulu, HI 96822-2845 | 2013-01-02 |
| 1073759882 | Vicky Marquez Crowder | Nurse Practitioner | 555 S. Beretania St, Ste 601, Honolulu, HI 96813 | 2008-12-29 |
| 1851413892 | Robin Evalena Caravallo | Nurse Practitioner | 98-1005 Moanalua Rd Spc 4020, Aiea, HI 96701 | 2007-04-03 |
| 1821194127 | Angela Moreschi Woods | Nurse Practitioner | 227 Mahalani St, Wailuku, HI 96793-2526 | 2006-09-15 |
| 1316904709 | Alice E Davis | Nurse Practitioner | 1059 Kilauea Ave Ste A, Hilo, HI 96720-4290 | 2006-04-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.