MRS. LAURA RENAE WILSON MSN APRN-BC NPI 1104032218

NPI Information

NPI: 1104032218
Provider Name: MRS. LAURA RENAE WILSON, MSN, APRN-BC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

Address:
5405 MEMORIAL DR STE D
STONE MOUNTAIN, GA
ZIP 30083
Phone: (404) 296-3800
Get Directions

MRS. Laura Renae Wilson, MSN, APRN-BC is a primary care nurse practitioner in Stone Mountain, GA. MRS. Laura Renae Wilson, MSN, APRN-BC NPI is 1104032218. 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:

5405 MEMORIAL DR STE D
STONE MOUNTAIN, GA
ZIP 30083-236
Phone: (404) 296-3800
Fax: (404) 297-8753

The enumeration date for this NPI number is 5/15/2007 and was last updated on 3/6/2019.

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	701633	TEXAS	No
2	363LF0000X	Nurse Practitioner	Family	004365	CONNECTICUT	No
3	363LP2300X	Nurse Practitioner	Primary Care	RN247115	GEORGIA	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	Other Provider Identifier Issuer
1	1649265646	OTHER	TEXAS	NPI- BRYAN- COLLEGE STATION CHC
2	1821185299	OTHER	TEXAS	NPI - BVCAA
3	1275620551	OTHER	TEXAS	NPI - ROBERTSON COUNTY CHC
4	154467803	MEDICAID	TEXAS

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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