MEDICARE: KEIARRA MARQUEL WILSON

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356971741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEIARRA MARQUEL WILSON

Provider Business Mailing Address
First Line	:	2622 WHITE CT
Second Line	:
City	:	COVINGTON
State	:	KY
Zip	:	41011-3950
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2622 WHITE CT
Second Line	:
City	:	COVINGTON
State	:	KY
Zip	:	41011-3950
Country	:	US
Telephone Number	:	513-696-2753
Fax Number	:

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

Provider Enumeration Date	:	01/24/2020
Last Update Date	:	01/24/2020

Similar Medicare Providers

1629469564 — KIMBERLY T JONES NP-C
Practice Location Address:

3950 NEW COVINGTON PIKE STE 220
MEMPHIS, TN
38128-2595

Practice Phone: 901-763-0200
Practice Fax: 901-516-5370

1750381430 — EDUARDO VIRTUCIO BASCO MD
Practice Location Address:

3950 NEW COVINGTON PIKE STE 220
MEMPHIS, TN
38128-2595

Practice Phone: 901-763-0200
Practice Fax: 901-761-4002

1659371235 — CLARO F DIAZ MD
Practice Location Address:

3950 NEW COVINGTON PIKE STE 220
MEMPHIS, TN
38128-2595

Practice Phone: 901-763-0200
Practice Fax: 901-516-5370

1215939350 — MS. MICHELLE L SCROGGINS APN
Practice Location Address:

3950 NEW COVINGTON PIKE STE 220
MEMPHIS, TN
38128-2595

Practice Phone: 901-763-0200
Practice Fax: 901-516-5370

1154391340 — NORTH SURGERY CENTER LP
Practice Location Address:

3950 NEW COVINGTON PIKE , SUITE 100
MEMPHIS, TN
38128

Practice Phone: 901-373-1991
Practice Fax: 901-516-1755

1417920273 — KEVIN M LUNSFORD MD
Practice Location Address:

3950 NEW COVINGTON PIKE , SUITE 200
MEMPHIS, TN
38128-2591

Practice Phone: 901-516-5644
Practice Fax: 901-516-5660

Directions to “ KEIARRA MARQUEL WILSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.