Healthcare Provider Details

I. General information

NPI: 1285434126
Provider Name (Legal Business Name): GEMINI HEALTH & WELLNESS NURSING CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 SUNRISE AVE STE 330
ROSEVILLE CA
95661-4146
US

IV. Provider business mailing address

406 SUNRISE AVE STE 330
ROSEVILLE CA
95661-4146
US

V. Phone/Fax

Practice location:
  • Phone: 916-547-8158
  • Fax: 866-390-0008
Mailing address:
  • Phone: 916-547-8158
  • Fax: 866-390-0008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM JARRETT WILSON
Title or Position: FAMILY NURSE PRACTITIONER
Credential: FNP
Phone: 916-918-1441