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JACKIE RAY WILSON NPI 1831835107


NPI Information

NPI: 1831835107
Provider Name: JACKIE RAY WILSON
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
119 W 2ND ST
STROUD, OK
ZIP 74079
Phone: (405) 328-1549
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Jackie Ray Wilson is a peer specialist in Stroud, OK. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Jackie Ray Wilson NPI is 1831835107. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

119 W 2ND ST
STROUD, OK
ZIP 74079-011
Phone: (405) 328-1549

The enumeration date for this NPI number is 5/10/2022 and was last updated on 12/16/2022.


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
1175T00000XPeer SpecialistYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.