Wilson, Kimberly Susann

Wilson, Kimberly Susann is an sole proprietor health care provider with primary practice located at 101 E Wood St , Spartanburg SC 29303-3040. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Wilson, Kimberly Susann can be contacted via phone (864) 560-6000.

Contact Information

Primary practice address
101 E Wood St Spartanburg SC 29303-3040
Phone: (864) 560-6000
Fax: (864) 560-7715
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 3974 South Carolina

Profile Details

NPI number 1689812802
LBN Legal business name Wilson, Kimberly Susann
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2009
Last updated Jan 18th, 2021 - about 3 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 1689812802 NPPES
South Carolina MEDICAID NP1547

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