MRS. SUSAN DIANE WILSON (NPI# 1568552487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568552487 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN DIANE WILSON |
| Credential | F.N.P. |
| Practice Address |
126 Missouri Ave Mcxp-ccs-cr Fort Leonard Wood MO 65473-8952 |
| Practice Telephone | 5735960417 |
| Practice Fax Number | 5735960524 |
| Mailing Telephone | 5735960417 |
| Mailing Fax Number | 5735960524 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2002021223 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891287306 | Susan Wilson | Technician | 11302 Sperry Stream Way, Bowie, MD 20720-3431 | 2018-05-31 |
| 1093202939 | Susan Faith Wilson | Counselor | 1555 Brae Moor Ln, Dunedin, FL 34698-3212 | 2018-04-17 |
| 1306358247 | Susan Wilson | Social Worker | 1931 Horton Rd Ste 3, Jackson, MI 49203-5599 | 2017-11-01 |
| 1780101857 | Susan C Wilson | Social Worker | 8135 Mount Vernon Rd., St. Lousiville, OH 43071 | 2017-08-29 |
| 1114466372 | Susan Kay Wilson | Social Worker | 919 Superior Dr, Huron, OH 44839-1454 | 2017-02-20 |
| 1831559111 | Susan Wilson | Case Manager/Care Coordinator | 24 Riverside Dr, Independence, VA 24348-3746 | 2016-03-01 |
| 1801284302 | Susan Lynn Wilson | Registered Nurse | 2988 Moyer Ave, Norton, OH 44203 | 2015-01-06 |
| 1558766105 | Susan Wilson | Social Worker | 318 Lake Marina Ave, 212, New Orleans, LA 70124-1600 | 2014-10-24 |
| 1366716854 | Susan Elizabeth Wilson | Midwife | 5410 Hill Crest St, Russellville, MO 65074-1213 | 2012-02-29 |
| 1477888261 | Susan Wilson | Licensed Practical Nurse | 17 E Haddon Ave, Oaklyn, NJ 08107-1308 | 2009-10-12 |
| Street Address |
126 MISSOURI AVE MCXP-CCS-CR |
| City | FORT LEONARD WOOD |
| State | MO |
| Zip Code | 65473-8952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336138643 | Thomas Houston Hume II | Physician Assistant | 126 Missouri Ave, Glwach Attn Mcxp Ccs Cr, Fort Leonard Wood, MO 65473-8952 | 2005-10-19 |
| 1881052504 | Allan Anthony Bolido | Nurse Anesthetist, Certified Registered | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2016-02-09 |
| 1801260625 | Bridget Farris | Technician | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2015-11-17 |
| 1992181515 | Brian Michael Lowery | Nurse Anesthetist, Certified Registered | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2015-08-05 |
| 1922480722 | Nathaniel Louis Fielding | Physician Assistant | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2015-06-29 |
| 1609289362 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 126 Missouri Ave, General Leonard Wood Army Community Hospital, Fort Leonard Wood, MO 65473-8952 | 2014-06-10 |
| 1033546148 | David F Boyd IIi | Nurse Practitioner | 126 Missouri Ave, General Leonard Wood Community Hospital, Fort Leonard Wood, MO 65473-8952 | 2013-10-03 |
| 1780022673 | Robert Eric Sapp Sr. | Pharmacist | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2013-06-12 |
| 1184061277 | Lachell Wardell | Pharmacist | 126 Missouri Ave, Stop (box #1240), Fort Leonard Wood, MO 65473-8952 | 2013-05-29 |
| 1114360351 | Gary Evans | Social Worker | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2013-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770192759 | Clara Boo Chai | Physician Assistant | General Leonard Wood Army Community Hospital, 4430 Missouri Ave, #1267, Fort Leonard Wood, MO 65473 | 2020-07-27 |
| 1982198453 | Traci Anne Shambo | Dental Hygienist | Bldg. 400 Virginia Ave, Fort Leonard Wood, MO 65473 | 2018-06-19 |
| 1083133771 | Mary Joan Klemp | Family Medicine | Ganeral Leonard Wood Army Community Hospital, 4430 Missouri Ave; Meddac Case Management; Primary Care, Fort Leonard Wood, MO 65473 | 2017-09-13 |
| 1255791851 | Sarah Elizabeth Joy | Physician Assistant | 885 West 16th Street, Fort Leonard Wood, MO 65473 | 2016-02-25 |
| 1548626948 | Jaimie-lee Musen | Physical Therapist | 4430 Missouri Ave, Glwach, Fort Leonard Wood, MO 65473 | 2016-01-14 |
| 1609240852 | Angela Carson | Registered Nurse | 4330 Missouri Avenue, Fort Leonard Wood, MO 65473 | 2015-11-25 |
| 1811379407 | Katharine Leigh Stringer | Dentist | 12720 Kansas Avenue, Fort Leonard Wood, MO 65473 | 2015-06-19 |
| 1548656044 | General Leonard Wood Army Community Hospital | Clinic/Center | 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 | 2015-04-10 |
| 1740670314 | Terricka Stewart | Specialist/Technologist | 885 West 16th St., Fort Leonard Wood, MO 65473 | 2015-02-03 |
| 1427467265 | Dianna Morrison | Social Worker | 4430 Missouri Ave Box 1278, Fort Leonard Wood, MO 65473 | 2014-08-06 |
| Find all providers in zip 65473 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084208 | Brenda Michelle Helton | Nurse Practitioner | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2020-08-17 |
| 1154840296 | Richkard Saint Louis | Nurse Practitioner | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2017-09-10 |
| 1437514098 | Ifesonye Emiloju Okwuchi | Nurse Practitioner | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2015-12-28 |
| 1033546148 | David F Boyd IIi | Nurse Practitioner | 126 Missouri Ave, General Leonard Wood Community Hospital, Fort Leonard Wood, MO 65473-8952 | 2013-10-03 |
| 1356696942 | Sean Lelen Harris | Nurse Practitioner | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2012-07-19 |
| 1689939100 | Nikki Racquel Bailey | Nurse Practitioner | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2012-07-10 |
| 1992713648 | Sandy Lee Sterling | Nurse Practitioner | 126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473-8952 | 2006-08-04 |
| 1609838424 | Jennifer Glidewell | Nurse Practitioner | 126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473-8952 | 2006-04-05 |
| 1871567438 | Risa Dee Bator | Nurse Practitioner | 126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473-8952 | 2006-02-13 |
| 1598747578 | Traci Mae Heese | Nurse Practitioner | 126 Missouri Ave, Glwach (attn: Sheila Ham), Fort Leonard Wood, MO 65473-8952 | 2005-11-16 |
| Find all providers in FORT LEONARD WOOD | ||||
| City | FORT LEONARD WOOD |
| Zip Code | 65473 |
Please comment or provide details below to improve the information on MRS. SUSAN DIANE 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.