BEVERLY CECILE WILSON (NPI# 1467703157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467703157 |
| Entity Type | Individual |
| Full Name | BEVERLY CECILE WILSON |
| Credential | FNP-BC |
| Practice Address |
3817 Main St Loris SC 29569-3017 |
| Mailing Address |
Po Box 547 Little River SC 29566-0547 |
| Practice Telephone | 8436638000 |
| Mailing Telephone | 8436638000 |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2015-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
17916 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP2188 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023552817 | Beverly N Wilson | Physician Assistant | 12038 Ocean Gateway, Unit 1, Ocean City, MD 21842 | 2016-12-13 |
| 1720386451 | Beverly Wilson | Massage Therapist | 700 Dalrymple Rd, 203, Atlanta, GA 30328-1414 | 2011-03-03 |
| 1811173719 | Beverly K Wilson | Counselor | 3425 Francis St, Jackson, MI 49203-5052 | 2008-01-10 |
| 1316158017 | Beverly Wilson | Social Worker | 8400 East Prentice Avenue, Suite 1401, Greenwood Village, CO 80111-2926 | 2007-05-24 |
| 1487747945 | Beverly A Wilson | Dentist | 1303 Dr. Martin L King Jr Ave, Mobile, AL 36603 | 2006-10-02 |
| 1457336521 | Beverly Deann Wilson | Pharmacist | 199 E Louise St, Clarkesville, GA 30523-6019 | 2005-12-13 |
| 1811449895 | Beverly Wilson | Counselor | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2016-10-26 |
| 1376908194 | Beverly Belk Wilson | Nurse Practitioner | 6840 Glenwood Ave, Raleigh, NC 27612-7133 | 2015-12-21 |
| 1942693429 | Beverly Wilson | Community Health Worker | 1230 2nd Ave, Columbus, GA 31901-5241 | 2015-03-09 |
| 1306248372 | Beverly Anne Wilson | Registered Nurse | 500 Crown Point Cir Ste 120, Grass Valley, CA 95945-9561 | 2014-09-22 |
| Street Address |
3817 MAIN ST |
| City | LORIS |
| State | SC |
| Zip Code | 29569-3017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619100096 | Little River Medical Center, Inc. | Family Medicine | 3817 Main St, Loris, SC 29569-3017 | 2009-09-01 |
| 1326303538 | Bernice Francesca Lim | Family Medicine | 3817 Main St, Loris, SC 29569-3017 | 2012-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427464247 | Denise Logan | Dietitian, Registered | 3811 Walnut St, Loris, SC 29569 | 2014-07-02 |
| 1801231634 | Melissa Ann Miara | Internal Medicine | 3617 Casey St Ste C, Loris, SC 29569 | 2013-05-07 |
| 1356684161 | Gwyn Gordon Mcgutchen | Dentist | 3681 Spivey St., Loris, SC 29569 | 2013-03-29 |
| 1336486174 | Winferd Dale Holt | Dentist | 3980 Main Street, Loris, SC 29569 | 2013-01-14 |
| 1528314325 | Southern Living Emergency Physicians LLC | Physician Assistant | 6988 Mitchell Street, Loris, SC 29569 | 2012-07-30 |
| 1124347604 | Regina F. Holmes | Nurse Practitioner | Agape Senior Primary Care Inc Dba Main Street Physician, 3612 Mitchell Street, Loris, SC 29569 | 2010-05-24 |
| 1801914122 | Dr Gwyn Gordon Mccutchen Inc | Dentist | 3681 Spivey Street, Loris, SC 29569 | 2007-03-26 |
| 1700911203 | Twin States Helping Hands | Home Health | 1620 Hwy 701 N, Loris, SC 29569 | 2007-02-23 |
| 1306922646 | Loris Community Hospital District | Clinic/Center | 3204 Casey St, Loris, SC 29569 | 2006-10-30 |
| 1619074119 | South Carolina Cvs Pharmacy LLC | Pharmacy | 4767 Broad St, Loris, SC 29569 | 2006-09-20 |
| Find all providers in zip 29569 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124347604 | Regina F. Holmes | Nurse Practitioner | Agape Senior Primary Care Inc Dba Main Street Physician, 3612 Mitchell Street, Loris, SC 29569 | 2010-05-24 |
| 1841285483 | Sarah J. Norris | Nurse Practitioner | 3418 Casey St, Loris, SC 29569-2904 | 2005-09-20 |
| 1205113248 | Mcleod Physician Associates II | Nurse Practitioner | 3109 Casey St, Loris, SC 29569-2807 | 2011-11-04 |
| 1316267396 | Donna C Sellers | Nurse Practitioner | 3109 Casey St, Suite A, Loris, SC 29569-2807 | 2010-06-01 |
| 1073684577 | Wanda W Grainger | Nurse Practitioner | 3109 Casey St, Suite A, Loris, SC 29569-2807 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557737 | Diondra Johnson | Nurse Practitioner | 2327 Watchtower Ln, Charleston, SC 29414-7803 | 2020-10-27 |
| 1740888262 | Gerri Kukucka | Nurse Practitioner | 18 Ash Ct, Irmo, SC 29063-9584 | 2020-10-16 |
| 1407454853 | William Andrew Haislip | Nurse Practitioner | 109 Anita St, Greer, SC 29651-3814 | 2020-10-16 |
| 1912505652 | Mattison Williams Craig | Nurse Practitioner | 108 Woodstock Ln, Greer, SC 29650-3918 | 2020-10-14 |
| 1669079901 | Kelley Brown Davis | Nurse Practitioner | 2689 Us-1, Elgin, SC 29045 | 2020-10-08 |
| 1518564897 | Erica Odom Mccumbers | Nurse Practitioner | 17 Downing Cir, Gilbert, SC 29054-8483 | 2020-10-08 |
| 1285231845 | Shannon Marie Dunlap | Nurse Practitioner | 3792 Home Branch Rd, Manning, SC 29102-4109 | 2020-10-07 |
| 1588261325 | Crystal Leopard | Nurse Practitioner | 328 Deer Creek Rd, Easley, SC 29640-7615 | 2020-10-05 |
| 1497352595 | Margaret Ann Regnery | Nurse Practitioner | 900 Island Park Dr Ste 104, Daniel Island, SC 29492-7560 | 2020-10-02 |
| 1417564709 | John P Rainchuso | Nurse Practitioner | 299 Three Runs Creek Way, Aiken, SC 29803-1680 | 2020-09-30 |
| 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.