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General NPI Number Information
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NPI Number | 1285469734
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Entity Type | Individual
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Provider Name | AMELIA WILSON RN, MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 1034 N 500 W
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City | PROVO
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State | UT
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Zip | 84604-3380
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Country | US
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Telephone | 801-357-7850
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Fax |
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Provider Business Mailing Address
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Address Line | 245 N 1900 W
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City | MAPLETON
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State | UT
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Zip | 84664-3475
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Country | US
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Telephone | 801-643-0415
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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 | 7498242-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 7498242-3102
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License Number State | UT
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