MS. WANDA FAYE WILSON (NPI# 1043643133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043643133 |
| Entity Type | Individual |
| Full Name | MS. WANDA FAYE WILSON |
| Practice Address |
2510 St Augustine Rd Monticello FL 32344-6938 |
| Practice Telephone | 8507800426 |
| Mailing Telephone | 8507800426 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906542 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 004873400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659872745 | Wanda Yvette Wilson | Home Health | 317 Office Square Ln Ste 201b, Virginia Beach, VA 23462-3663 | 2018-02-23 |
| 1619002565 | Wanda N Wilson | Registered Nurse | 1650 Harvey Ln, Denison, TX 75020-0674 | 2007-02-22 |
| 1033182118 | Wanda Gayle Wilson | General Practice | 3559 Amazonas St, Jefferson City, MO 65109 | 2006-02-09 |
| 1760836282 | Wanda Wilson | Specialist | 2925 Debarr Rd, Suite 150, Anchorage, AK 99508-2959 | 2016-04-21 |
| 1265650758 | Wanda Wilson | Counselor | 51 N St Ne, Washington, DC 20002-3347 | 2007-04-23 |
| 1083734081 | Wanda Leah Wilson | Registered Nurse | 909 Alameda St, Norman, OK 73071-5229 | 2007-03-31 |
| 1225183387 | Wanda M Wilson | Counselor | 2814 W 2nd St, Wilmington, DE 19805-1807 | 2007-01-25 |
| 1538100524 | Wanda O Wilson | Nurse Anesthetist, Certified Registered | 234 Goodman St, Cincinnati, OH 45219-2364 | 2006-06-09 |
| Street Address |
2510 ST AUGUSTINE RD |
| City | MONTICELLO |
| State | FL |
| Zip Code | 32344-6938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851875355 | Pedro Enrique Maseda | Physical Medicine & Rehabilitation | Brynwood Health Rehab, 1656 Jefferson Street, Monticello, FL 32344 | 2018-09-20 |
| 1821482142 | Krista L Mcmullen | Licensed Practical Nurse | 1255 West Washington Street, Monticello, FL 32344 | 2015-03-25 |
| 1861689994 | Ellen Hamilton | Social Worker | 5877 North Salt Road, Monticello, FL 32344 | 2007-10-03 |
| 1891898383 | Joseph C Dorn | Family Medicine | 193 Nursery Rd, Monticello, FL 32344 | 2006-09-07 |
| 1972569770 | Judy Ann Kleynen | Family Medicine | 1549 S. Jefferson Street, Monticello, FL 32344 | 2006-04-21 |
| 1770549545 | Wesley Douglas Scoles | Family Medicine | 1549 South Jefferson Steet, Monticello, FL 32344 | 2006-04-21 |
| 1396880654 | County of Jefferson Office of Clerk Circuit Court | Ambulance | 1456 S. Jefferson St, Monticello, FL 32344-0000 | 2007-02-21 |
| 1902047939 | True Blue Doulas, Inc | Community Health Worker | 680 W Halpin Rd, Monticello, FL 32344-0310 | 2009-03-21 |
| 1548860265 | Clinton Brad Wilson | Pharmacist | 650 Hiawatha Farms Rd, Monticello, FL 32344-0821 | 2020-10-30 |
| 1720590565 | Angela Decker Markley | Nurse Practitioner | 365 Holly Rd, Monticello, FL 32344-1011 | 2017-11-02 |
| Find all providers in zip 32344 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912540428 | Jennifer Lashon May | Custodial Care Facility | 141 Jefferson Street Ste, C, Monticello, MS 39654-3965 | 2019-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497243 | Two Kinds of Hearts 'llc' | Custodial Care Facility | 1808 Oak Pond Street, Ruskin, FL 33570 | 2020-11-03 |
| 1881293843 | Inspire Family Home Care LLC. | Custodial Care Facility | 566 Forsyth Creek Ct, Apopka, FL 32712-3318 | 2020-10-21 |
| 1336747658 | Eddrena Thornton | Custodial Care Facility | 2233 Bluebird Ave, Bartow, FL 33830-2953 | 2020-10-09 |
| 1689280083 | Wendy Del Rosario Toledo Machado | Custodial Care Facility | 7101 Green St, New Port Richey, FL 34652-1630 | 2020-09-21 |
| 1568077469 | Titilayo M Dipe | Custodial Care Facility | 11215 Gold Compass St, Gibsonton, FL 33534-5698 | 2020-09-09 |
| 1124630892 | Moselene Belizaire | Custodial Care Facility | 3411 9th St W, Lehigh Acres, FL 33971-5357 | 2020-08-23 |
| 1396354395 | Unique Adult Family Care Home Inc. | Custodial Care Facility | 7149 Glenwood Dr, Boynton Beach, FL 33436-9404 | 2020-07-24 |
| 1790301687 | Nancy Isidor | Custodial Care Facility | 1728 Burnham Ct, Clermont, FL 34714-8048 | 2020-06-17 |
| 1326662206 | Yuwaret Haines | Custodial Care Facility | 13566 Rudi Loop, Spring Hill, FL 34609-7964 | 2020-06-05 |
| 1245854686 | Yves Carmen Dorsainvil | Custodial Care Facility | 631 Sw Sardinia Ave, Port Saint Lucie, FL 34953-3746 | 2020-06-01 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 32344 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.