MRS. KIMBERLY ELLISON WILSON (NPI# 1285826057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285826057 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY ELLISON WILSON |
| Credential | CRNP |
| Practice Address |
1325 Mcfarland Blvd Suite 104 Northport AL 35476-3270 |
| Practice Telephone | 2053305266 |
| Practice Fax Number | 2053309915 |
| Mailing Telephone | 2053305266 |
| Mailing Fax Number | 2053309915 |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2012-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-078924 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS OF ALABAMA | 511-00428 | 01 |
| AL | 115069/1336474964 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407465420 | Kimberly Frances Wilson | Doula | 6911 Deorsam Loop, Killeen, TX 76542-6377 | 2020-07-26 |
| 1689132250 | Kimberly Jo Wilson | Registered Nurse | 3765 King Rd, Saginaw, MI 48601-7146 | 2019-03-03 |
| 1265905038 | Kimberly Ann Wilson | Speech-Language Pathologist | 658 Lions Gate Ln, Odenton, MD 21113-1490 | 2019-01-04 |
| 1114462793 | Kimberly Wilson | Social Worker | 1820 T St Nw Apt 2, Washington, DC 20009-7144 | 2017-01-05 |
| 1841749439 | Kimberly Ann Wilson | Nurse Practitioner | 4333 S 172nd East Ave, Tulsa, OK 74134-7281 | 2016-09-24 |
| 1700246709 | Kimberly Moss Wilson | Counselor | 1116 E Ponce De Leon Ave, Decatur, GA 30030-2711 | 2016-03-03 |
| 1427451939 | Kimberly Wilson | Occupational Therapist | 6608 Covington Cv, Canfield, OH 44406-8161 | 2014-09-29 |
| 1083036701 | Kimberly Wilson | Social Worker | 6210 Belcrest Rd Apt 1228, Hyattsville, MD 20782-2967 | 2014-01-15 |
| 1801220579 | Kimberly Patrice Wilson | Counselor | 205 North Liberty St, Centreville, MD 21617 | 2013-08-29 |
| 1164795704 | Kimberly Renee Wilson | Speech-Language Pathologist | 107 S Keswick Ave, Glenside, PA 19038-4509 | 2012-02-13 |
| Street Address |
1325 MCFARLAND BLVD SUITE 104 |
| City | NORTHPORT |
| State | AL |
| Zip Code | 35476-3270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174504336 | Luis Ronald Pernia | Specialist | 1325 Mcfarland Blvd, Suite 201, Northport, AL 35476-3270 | 2005-11-07 |
| 1780034066 | Michael Christopher Jordan | Specialist/Technologist | 1325 Mcfarland Blvd, Northport, AL 35476-3270 | 2016-06-16 |
| 1073962833 | Sarah Clos | Specialist/Technologist | 1325 Mcfarland Blvd, Northport, AL 35476-3270 | 2016-06-12 |
| 1548643273 | Randi Cheree Melton | Family Medicine | 1325 Mcfarland Blvd, Suite 102, Northport, AL 35476-3270 | 2015-06-30 |
| 1316320054 | Amy Lee Wambolt | Student in an Organized Health Care Education/Training Program | 1325 Mcfarland Blvd, Suite 102, Northport, AL 35476-3270 | 2015-06-30 |
| 1275926719 | Capstone Health Services Foundation PC | Clinic/Center | 1325 Mcfarland Blvd, Suite 102, Northport, AL 35476-3270 | 2015-03-09 |
| 1750798534 | Jessica Hester | Nurse Practitioner | 1325 Mcfarland Blvd, Ste 101, Northport, AL 35476-3262 | 2014-07-14 |
| 1487901369 | Kyle David Adams | Specialist/Technologist | 1325 Mcfarland Blvd, Northport, AL 35476-3270 | 2012-08-09 |
| 1689980484 | Flh, Inc. | Physical Medicine & Rehabilitation | 1325 Mcfarland Blvd, Suite 101, Northport, AL 35476-3270 | 2010-08-31 |
| 1881841500 | April L Coleman | Physician Assistant | 1325 Mcfarland Blvd, Suite 102, Northport, AL 35476-3270 | 2008-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669942728 | Dch Encore Rehabilitation, LLC | Clinic/Center | Dch Encore Rehabilitation, LLC, 92 Mcfarland Blvd, Northport, AL 35476 | 2018-12-03 |
| 1821592189 | Julia Madrid | Counselor | 1905 4th St Ste 4, Northport, AL 35476 | 2018-03-21 |
| 1740652395 | Restoring Piece LLC | Community/Behavioral Health | 433 Main Avenue, Northport, AL 35476 | 2015-10-22 |
| 1316363740 | Alabama Bariatric and Wellness | Internal Medicine | 1325 Mcfarland Blvd. Suite #209, Northport, AL 35476 | 2014-03-10 |
| 1104170406 | Kerry Thomas, Hill | Chiropractor | 1580 Lurleen Wallace Blvd., Northport, AL 35476 | 2012-11-08 |
| 1366794703 | Back To Fitness | Chiropractor | 1580 Lorleen Wallace Blvd., Northport, AL 35476 | 2012-10-10 |
| 1740532357 | Andrea Austin Barry | Nurse Practitioner | 920 Rose Dr., Northport, AL 35476 | 2012-10-05 |
| 1184995953 | Julie T Guy | Pharmacist | 3107 Lurleen B Wallace Boulevard, Northport, AL 35476 | 2012-01-25 |
| 1427280973 | Ida Denise Robinson | Internal Medicine | 2201 Mcfarland Blvd., Northport, AL 35476 | 2009-08-18 |
| 1700017852 | Bony F Barrineau Md PC | Orthopaedic Surgery | 2201 32nd Street, Northport, AL 35476 | 2009-08-06 |
| Find all providers in zip 35476 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003432568 | Jacqueline Elaine White | Nurse Practitioner | 3105 31st Ave, Northport, AL 35476-5240 | 2020-06-22 |
| 1164042586 | Ashleigh Nicole Morris | Nurse Practitioner | 800 Energy Center Blvd Apt 3109, Northport, AL 35473-2732 | 2020-04-26 |
| 1033609748 | Kara Lynne Pate | Nurse Practitioner | 5710 Watermelon Rd Ste 600, Northport, AL 35473 | 2018-05-17 |
| 1881046647 | Sharon Ann Hawkins | Nurse Practitioner | 11401 Saint James Ct, Northport, AL 35475-4430 | 2016-07-05 |
| 1629497508 | Lauren Hanley | Nurse Practitioner | 4280 Watermelon Rd Ste 110, Northport, AL 35473 | 2014-04-08 |
| 1356612873 | David Clark Bailey Jr. | Nurse Practitioner | 2810 Lurleen B Wallace Blvd, Northport, AL 35476-3249 | 2012-01-13 |
| 1124113394 | Susanne Mills Snider | Nurse Practitioner | 2810 Lurleen Wallace Blvd, Northport, AL 35476-3249 | 2006-10-04 |
| 1417953092 | Mary Anne Dumas | Nurse Practitioner | Nurse Practitioner, Yellow Primary Care Clinic, Vamc, 76 Middleville Road, Northport, NY 11743 | 2005-06-28 |
| 1790398469 | Shelby Leanne Bowden | Nurse Practitioner | 1325 Mcfarland Blvd Ste 204, Northport, AL 35476-3275 | 2020-08-24 |
| 1598381097 | Shelby S Warren | Nurse Practitioner | 4410 Watermelon Rd, Northport, AL 35473-5204 | 2020-06-19 |
| Find all providers in NORTHPORT | ||||
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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.