Wilson, Kathy A.

Wilson, Kathy A. is an sole proprietor health care provider with primary practice located at 2010 Lewis Turner Blvd , Fort Walton Beach FL 32547-1352. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wilson, Kathy A. can be contacted via phone (850) 863-3000.

Contact Information

Primary practice address
2010 Lewis Turner Blvd Fort Walton Beach FL 32547-1352
Phone: (850) 863-3000
Fax: (850) 862-1621
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9162558 Florida

Profile Details

NPI number 1174508915
LBN Legal business name Wilson, Kathy A.
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 14th, 2005
Last updated Sep 12th, 2017 - about 7 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 1174508915 NPPES
Florida MEDICAID 303882300

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