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General NPI Number Information
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NPI Number | 1073071999
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Entity Type | Individual
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Provider Name | EMILY M WILSON APRN
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Gender | Female
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Dates
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Enumeration Date | 03/10/2019
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 9080 TAYLORSVILLE RD
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City | LOUISVILLE
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State | KY
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Zip | 40299-1750
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Country | US
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Telephone | 502-499-9998
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3012791
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License Number State | KY
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