MEDICARE: JENEVA JILL WILSON LPN

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1598489635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENEVA JILL WILSON LPN

Provider Business Mailing Address
First Line	:	1212 MARYS GROVE CHURCH RD
Second Line	:
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-9466
Country	:	US
Telephone Number	:	980-341-9535
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212 MARYS GROVE CHURCH RD
Second Line	:
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-9466
Country	:	US
Telephone Number	:	980-341-9535
Fax Number	:

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

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	10/03/2022

Similar Medicare Providers

1851597421 — R.K.HUGHES INC.
Practice Location Address:

1212 MARYS GROVE CHURCH RD
KINGS MOUNTAIN, NC
28086-9466

Practice Phone: 704-445-6253
Practice Fax:

1225244767 — KATHRYN M BOVINO M.A., B.C.B.A.
Practice Location Address:

9466 BLACK MOUNTAIN RD STE 100
SAN DIEGO, CA
92126-4550

Practice Phone: 858-689-2027
Practice Fax: 858-397-2172

1467600718 — DEANNA BELLAMA-POSTE
Practice Location Address:

9466 BLACK MOUNTAIN RD STE 100
SAN DIEGO, CA
92126-4550

Practice Phone: 858-689-2027
Practice Fax:

1891020822 — MARCY ANNA EDSON M.S. SLP
Practice Location Address:

9466 BLACK MOUNTAIN RD
SAN DIEGO, CA
92126-4550

Practice Phone: 858-689-2027
Practice Fax:

1184932949 — MRS. BLAKE KRISTOL BAUM
Practice Location Address:

9466 BLACK MOUNTAIN RD STE 100
SAN DIEGO, CA
92126-4550

Practice Phone: 858-689-2027
Practice Fax:

1225333214 — DR. KIM CATHERINE VAN DUSEN PSY.D., LMFT, RPT
Practice Location Address:

9466 BLACK MOUNTAIN RD STE 100
SAN DIEGO, CA
92126-4550

Practice Phone: 858-689-2027
Practice Fax:

Directions to “ JENEVA JILL WILSON LPN” 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.