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General NPI Number Information
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NPI Number | 1154496040
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Entity Type | Individual
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Provider Name | JESSICA ANN WILSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/23/2006
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 9149 ESTATE THOMAS PARAGON BLDG STE 202
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City | ST THOMAS
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State | VI
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Zip | 00802-2615
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Country | US
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Telephone | 340-776-5507
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Fax | 340-776-7935
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Provider Business Mailing Address
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Address Line | 9149 ESTATE THOMAS PARAGON BLDG STE 202
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City | ST THOMAS
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State | VI
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Zip | 00802-2615
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Country | US
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Telephone | 340-776-5507
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Fax | 340-776-7935
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 251287
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 52351-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 52351-20
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 251287
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | SP1377
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License Number State | VI
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | SP1377
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License Number State | VI
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