Wilson, Kristal Lee Ann
Wilson, Kristal Lee Ann is an individual health care provider with primary practice located at 10302 Brookridge Village Blvd Ste 103-104 , Louisville KY 40291-4475. She recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as her primary health care specialty. Wilson, Kristal Lee Ann can be contacted via phone (502) 276-5300.Contact Information
Primary practice address
10302 Brookridge Village Blvd Ste 103-104
Louisville KY 40291-4475
Phone: (502) 276-5300
Fax: (502) 576-5376
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 01084557A | Indiana |
Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 48792 | Kentucky |
Profile Details
NPI number | 1578853602 |
---|---|
LBN Legal business name | Wilson, Kristal Lee Ann |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 11th, 2011 |
Last updated | Oct 11th, 2023 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1578853602 | NPPES |
Kentucky | MEDICAID | 7100212070 | |
Kentucky | MEDICAID | 201298810 |
Popular Providers
-
Buckman, Brigid M
2400 Eastpoint Pkwy Suite 410, Louisville KY 40223-4154 -
Anderson, David Michael
9702 Stonestreet Rd Ste 120 , Louisville KY 40272-6812 -
Reasor, Gary Lloyd
400 Executive Park , Louisville KY 40207-4204 -
Sutton, Brandon Michael
1169 Eastern Pkwy , Louisville KY 40217-1417 -
Beacham, Timothy
4201 Springhurst Blvd Ste 102 , Louisville KY 40241-6156 -
Haney, Bill Walker
6400 Dutchmans Pkwy Ste 60 , Louisville KY 40205-3341 -
Jackson, James W
120 Executive Park , Louisville KY 40207 -
Weber, David A
4130 Dutchmans Ln Suite 104, Louisville KY 40207-4713