ANASTASIA DESIREE WILSON (NPI# 1295209500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295209500 |
| Entity Type | Individual |
| Full Name | ANASTASIA DESIREE WILSON |
| Credential | APRN |
| Practice Address |
5210 Grand Ave Fort Smith AR 72904-7362 |
| Mailing Address |
71 Crestridge Dr Dover AR 72837-8716 |
| Practice Telephone | 4797887444 |
| Mailing Telephone | 4798319530 |
| Enumeration Date | 2019-01-20 |
| Last Update Date | 2019-01-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
A005985 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2210 Robinson Ave, Conway, AR 720344943 | 4797887444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710533815 | Anastasia R Wilson | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2019-08-14 |
| Street Address |
5210 GRAND AVE |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72904-7362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295976694 | Adrian Rae Tribble | Specialist/Technologist | 5210 Grand Ave, Fort Smith, AR 72904-7362 | 2009-03-13 |
| 1851934038 | Matthew Haisch | Specialist/Technologist | 5210 Grand Ave, Fort Smith, AR 72904-7362 | 2019-10-21 |
| 1770003907 | Kelby Chambers | Specialist/Technologist | 5210 Grand Ave, Fort Smith, AR 72904-7362 | 2017-06-20 |
| 1255861092 | Brian O'connor | Specialist/Technologist | 5210 Grand Ave, Fort Smith, AR 72913 | 2017-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871072751 | Baptist Health Services | Family Medicine | 4700 Kelley Hwy Ste A, Fort Smith, AR 72904 | 2018-08-10 |
| 1649799081 | Timothy Morris | Case Manager/Care Coordinator | 5900 Kinkead Ave 477, Fort Smith, AR 72904 | 2017-09-18 |
| 1326564980 | Lyndy Luree Raley | Speech-Language Pathologist | 3300 Harris Ave., Fort Smith, AR 72904 | 2017-08-16 |
| 1104175280 | Chelsea Beth Phillips Claybrook | Physical Therapy Assistant | 1801 South 74th St., Fort Smith, AR 72904 | 2012-09-05 |
| 1437408762 | Misty Denise Flemming | Physical Therapy Assistant | 4401 Yorkshire Dr., Fort Smith, AR 72904 | 2012-08-31 |
| 1831473321 | Rebecca Lynn Reif | Speech-Language Pathologist | 5100 Kelley Highway, Fort Smith, AR 72904 | 2011-10-03 |
| 1760542443 | Neill Hamilton Treece | Dentist | 1528 No 39th, Fort Smith, AR 72904 | 2006-12-11 |
| 1285690842 | Fort Smith Home Health Agency Inc | Home Infusion | 220 N 12th Street, Ft Smith, AR 72904 | 2006-04-24 |
| 1659850329 | Baptist Health Services | Internal Medicine | 4700 Kelley Hwy Ste B, Fort Smith, AR 72904 | 2018-08-13 |
| 1437410545 | Susan Lynn Mcdaniel | Nurse Practitioner | 4900 Kelley Hwy, Fort Smith, AR 72904 | 2012-06-05 |
| Find all providers in zip 72904 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598308140 | Elizabeth Ann Charles | Nurse Practitioner | 7001 Rogers Ave Fl 6, Fort Smith, AR 72903-4073 | 2019-10-25 |
| 1194024158 | Melanie Anne Gramling | Nurse Practitioner | 7001 Rogers Ave Ste 401, Fort Smith, AR 72903-4034 | 2011-03-16 |
| 1093218042 | Stacy L North-flanagan | Nurse Practitioner | 1420 S I St, Fort Smith, AR 72901 | 2018-03-15 |
| 1093193823 | Jennifer Rebecca Tetirick | Nurse Practitioner | 1001 Towson Ave, Fort Smith, AR 72901-4921 | 2015-05-13 |
| 1558752535 | Chasidy Mcallister | Nurse Practitioner | 1001 Towson Ave, Fort Smith, AR 72901-4921 | 2015-02-11 |
| 1386042927 | Mandy Lee Fluitt | Nurse Practitioner | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2014-12-14 |
| 1114329497 | Travis Walling | Nurse Practitioner | 1000 S Waldron Rd, Fort Smith, AR 72903-4278 | 2014-09-18 |
| 1316361009 | Lou Ann Parker | Nurse Practitioner | 616 S 17th St, Fort Smith, AR 72901-4700 | 2014-02-14 |
| 1851714562 | Stacia Wehunt | Nurse Practitioner | 1500 Dodson Ave, Suite 250, Fort Smith, AR 72901-5182 | 2014-01-31 |
| 1578818621 | Paula Joann Brosnan | Nurse Practitioner | 7001 Rogers Ave Ste 200, Fort Smith, AR 72903-4022 | 2012-07-16 |
| Find all providers in FORT SMITH | ||||
| City | FORT SMITH |
| Zip Code | 72904 |
Please comment or provide details below to improve the information on ANASTASIA DESIREE WILSON.
| 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.