Wilson, Alicia Ann

Wilson, Alicia Ann is an individual health care provider with primary practice located at 400 E Tickle St , Dyersburg TN 38024-3120. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Wilson, Alicia Ann can be contacted via phone (731) 288-3610.

Contact Information

Primary practice address
400 E Tickle St Dyersburg TN 38024-3120
Phone: (731) 288-3610
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 150829 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4000583 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 14842 Tennessee

Profile Details

NPI number 1649509332
LBN Legal business name Wilson, Alicia Ann
Credentials RN, MSN, FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2009
Last updated Apr 17th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649509332 NPPES
Tennessee MEDICAID 1521553

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