MEDICARE: DANA M WILSON DNP, APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	RN220371	GA

General Provider Information

NPI Number	:	1518383959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA M WILSON DNP, APRN, FNP-C

Provider Business Mailing Address
First Line	:	1310 ROCKBRIDGE RD STE F
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30087-3163
Country	:	US
Telephone Number	:	770-864-5538
Fax Number	:	404-393-4038

Provider Business Practice Location Address
First Line	:	1310 ROCKBRIDGE ROAD, SW
Second Line	:	SUITE F
City	:	STONE MTN
State	:	GA
Zip	:	30087
Country	:	US
Telephone Number	:	770-864-5538
Fax Number	:	404-393-4038

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

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	10/09/2025

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