Healthcare Provider Details

I. General information

NPI: 1740113919
Provider Name (Legal Business Name): ANDREW SCOTT WILSON RN, MSN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4238 NEW NATCHITOCHES RD
WEST MONROE LA
71292-2142
US

IV. Provider business mailing address

4238 NEW NATCHITOCHES RD
WEST MONROE LA
71292-2142
US

V. Phone/Fax

Practice location:
  • Phone: 318-334-2168
  • Fax:
Mailing address:
  • Phone: 318-334-2168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number223399
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: