MEDICARE: JENNIFER BYUN WILSON FNP

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	363L00000X	Nurse Practitioner	AP135975	TX

General Provider Information

NPI Number	:	1629583679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER BYUN WILSON FNP

Provider Business Mailing Address
First Line	:	3800 CADET LN
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-7149
Country	:	US
Telephone Number	:	318-450-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 ELDORADO PKWY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070
Country	:	US
Telephone Number	:	972-569-2700
Fax Number	:

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

Provider Enumeration Date	:	12/12/2017
Last Update Date	:	03/24/2026

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