MS. MELISSA LOUISE WILSON FAMILY NURSE PRACTIT NPI 1700873528

NPI Information

NPI: 1700873528
Provider Name: MS. MELISSA LOUISE WILSON, FAMILY NURSE PRACTIT
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
524 SPRUCE STREET UNIT 3
BROOKINGS, OR
ZIP 97415
Phone: (541) 412-3726
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MS. Melissa Louise Wilson, FAMILY NURSE PRACTIT is a family nurse practitioner in Brookings, OR. MS. Melissa Louise Wilson, FAMILY NURSE PRACTIT NPI is 1700873528. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

524 SPRUCE STREET UNIT 3
BROOKINGS, OR
ZIP 97415
Phone: (541) 412-3726
Fax: (541) 412-3729

The enumeration date for this NPI number is 10/6/2005 and was last updated on 6/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	N32717	IDAHO	No
2	367A00000X	Advanced Practice Midwife		N32717	IDAHO	No
3	367A00000X	Advanced Practice Midwife				No
4	363LF0000X	Nurse Practitioner	Family	201350121NP	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	9639428	MEDICAID	WASHINGTON
2	806760300	MEDICAID	IDAHO
3	P48049	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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