Wilson, Jimmy-John Clifford

Wilson, Jimmy-John Clifford is an individual health care provider with primary practice located at 2080 W Arlington Blvd Ste B , Greenville NC 27834. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Wilson, Jimmy-John Clifford can be contacted via phone (252) 752-2140.

Contact Information

Primary practice address
2080 W Arlington Blvd Ste B Greenville NC 27834
Phone: (252) 752-2140
Fax: (252) 689-6502
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 075318 North Carolina
Nursing Service Providers / Registered Nurse 163W00000X 162260 North Carolina

Profile Details

NPI number 1194875112
LBN Legal business name Wilson, Jimmy-John Clifford
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Jul 24th, 2020 - about 4 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 1194875112 NPPES
North Carolina MEDICAID 8052804
North Carolina Other P00408503

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