Wilson, Kimberly Ellison

Wilson, Kimberly Ellison is an individual health care provider with primary practice located at 1325 Mcfarland Blvd Suite 104, Northport AL 35476-3270. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wilson, Kimberly Ellison can be contacted via phone (205) 330-5266.

Contact Information

Primary practice address
1325 Mcfarland Blvd Suite 104 Northport AL 35476-3270
Phone: (205) 330-5266
Fax: (205) 330-9915
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1-078924 Alabama

Profile Details

NPI number 1285826057
LBN Legal business name Wilson, Kimberly Ellison
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2007
Last updated Sep 25th, 2012 - about 12 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 1285826057 NPPES
Alabama Other 511-00428 BCBS OF ALABAMA
Alabama MEDICAID 115069/1336474964 BCBS OF ALABAMA

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