Healthcare Provider Details

I. General information

NPI: 1285433490
Provider Name (Legal Business Name): BRITTANY WILSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 MEDICAL PKWY STE 200
CEDAR PARK TX
78613-2778
US

IV. Provider business mailing address

320 GIDRAN TRL
GEORGETOWN TX
78626-4939
US

V. Phone/Fax

Practice location:
  • Phone: 512-341-0900
  • Fax:
Mailing address:
  • Phone: 512-906-6685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1192534
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: