KIM MARIE WILSON (NPI# 1639383474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639383474 |
| Entity Type | Individual |
| Full Name | KIM MARIE WILSON |
| Credential | CRNP |
| Practice Address |
3400 Spruce St 4 Dulles Building Philadelphia PA 19104-4206 |
| Mailing Address |
3400 Spruce St 4 Dulles Bldg Philadelphia PA 19104-4206 |
| Practice Telephone | 2156154949 |
| Mailing Telephone | 2156154949 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | TP004563U | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245725365 | Kim Marie Wilson | Registered Nurse | 211 201st Ave Ne, Snohomish, WA 98290-9613 | 2018-06-30 |
| 1639583669 | Kim Wilson | Home Health | 136 Field Pine Ave, Hopkins, SC 29061-9501 | 2014-06-18 |
| 1073532438 | Kim Yvette Wilson | Pharmacist | 3800 Fletcher Ave, Suite 133, Tampa, FL 33613 | 2006-07-18 |
| 1134169311 | Kim Dittis Wilson | Nurse Practitioner | 900 E Michigan Ave Ste 105, Jackson, MI 49201-2490 | 2006-06-07 |
| 1033584966 | Kim Wilson | Counselor | 25 Gap Rd, Batesville, AR 72501-8679 | 2015-12-03 |
| 1073982245 | Kim Wilson | Physician Assistant | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2015-09-17 |
| 1134398126 | Kim Yung Wilson | Occupational Therapist | 14701 Cecil Dr, Little Rock, AR 72223-1913 | 2008-02-25 |
| 1821215781 | Kim Badell Wilson | Dentist | 288 Northwood Ave, Jasper, IN 47546-1212 | 2007-04-19 |
| 1124194006 | Kim A Wilson | Pediatrics | 75 Bickford St, Martha Eliot Health Center, Jamaica Plain, MA 02130-1401 | 2006-11-24 |
| 1457468928 | Kim Wilson | Radiology | 3601 S 6th Ave, Tucson, AZ 85723-0001 | 2006-08-23 |
| Street Address |
3400 SPRUCE ST 4 DULLES BUILDING |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063415966 | Samuel Isaiah Parry | Obstetrics & Gynecology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2005-05-24 |
| 1831790609 | Renate Marie Balitzky | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-11-06 |
| 1053911156 | Jordan Charles Templeton | Physician Assistant | 3400 Spruce St, Philadelphia, PA 19104-4274 | 2020-10-28 |
| 1992305304 | Alyssa N Volpe | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-27 |
| 1700486115 | Christina Haddow | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-27 |
| 1629677497 | Marissa Leigh Berlant | Physician Assistant | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-22 |
| 1811595523 | Kristen Gilgen | Anesthesiology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-14 |
| 1962014654 | Stacey Pham | Nurse Practitioner | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-08-23 |
| 1265040109 | Abdullah T Almuqate | Pathology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-07-16 |
| 1952928541 | Stefen Andrianus | Student in an Organized Health Care Education/Training Program | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922619642 | Michelle Marie Platzer | Nurse Practitioner | 1238 N Mascher St, Philadelphia, PA 19122-4617 | 2020-08-14 |
| 1801411855 | Betty Sophia Glauberzon | Nurse Practitioner | 1810 Rittenhouse Sq Apt 2104, Philadelphia, PA 19103-5830 | 2020-06-15 |
| 1356966717 | Lorraine Denise Hicks | Nurse Practitioner | 7923 Gilbert St, Philadelphia, PA 19150-2505 | 2020-06-11 |
| 1740813682 | Marina Rakitskaya | Nurse Practitioner | 9816 Bonner St, Philadelphia, PA 19115-2304 | 2020-02-19 |
| 1841755014 | Kristen M Wright | Nurse Practitioner | 925 Chestnut St Apt 323a, Philadelphia, PA 19107-4216 | 2019-02-01 |
| 1649745241 | Chermal Rondell Moore | Nurse Practitioner | 1017 W Beacon St, Philadelphia, MS 39350-3218 | 2018-10-10 |
| 1588148175 | Eileen Mangabat Hummel | Nurse Practitioner | 3900 Woodland Ave # 127, Philadelphia, PA 19104-4551 | 2018-09-19 |
| 1225532344 | Stacy Lynn Brix | Nurse Practitioner | 4417 N 6th St # 2319, Philadelphia, PA 19140-2319 | 2018-03-22 |
| 1275037087 | Esther Andreessen | Nurse Practitioner | 3457 Eden St, Philadelphia, PA 19114-3605 | 2018-03-19 |
| 1265931570 | Maia Lindsey Francis | Nurse Practitioner | 2301 E Allegheny Ave Ste 203, Philadelphia, PA 19134-4427 | 2018-02-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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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.