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General NPI Number Information
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NPI Number | 1578142204
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Entity Type | Individual
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Provider Name | KASEY HAWKINS WILSON MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 801 PRINCETON AVE SW
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City | BIRMINGHAM
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State | AL
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Zip | 35211-1310
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Country | US
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Telephone | 205-780-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 1274 MOUNT CARMEL RD
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City | ALTOONA
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State | AL
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Zip | 35952-9111
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Country | US
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Telephone | 256-298-6768
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-151976
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License Number State | AL
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