MEDICARE: CHRISTI L. WILSON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	1-121650	AL
2	363LF0000X	Family Nurse Practitioner	1-121650	AL

General Provider Information

NPI Number	:	1083256465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTI L. WILSON NP

Provider Business Mailing Address
First Line	:	6 WILSON DR
Second Line	:
City	:	CAMDEN
State	:	AL
Zip	:	36726-1835
Country	:	US
Telephone Number	:	52-913-3156
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 INDUSTRIAL DR W
Second Line	:
City	:	PINE HILL
State	:	AL
Zip	:	36769-3369
Country	:	US
Telephone Number	:	334-963-2113
Fax Number	:	334-963-2116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2019
Last Update Date	:	07/18/2024

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