MRS. KATHERINE ANN WILSON (NPI# 1235353988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235353988 |
| Entity Type | Individual |
| Full Name | MRS. KATHERINE ANN WILSON |
| Credential | PA-C |
| Practice Address |
559 W Twincourt Trl Unit 601 St Augustine FL 32095-8805 |
| Mailing Address |
Po Box 45443 Salt Lake City UT 84145-0443 |
| Practice Telephone | 9049401441 |
| Practice Fax Number | 9049401490 |
| Mailing Telephone | 9042021032 |
| Mailing Fax Number | 9043764107 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2018-12-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9104552 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 005035 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 411072211A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245798487 | Katherine Denise Wilson | Speech-Language Pathologist | 1901 Tarboro St Sw Ste 301, Wilson, NC 27893-3479 | 2019-03-06 |
| 1437519907 | Katherine Elizabeth Wilson | Physical Therapist | 5372 B Old Virginia St, Urbanna, VA 23175 | 2016-02-26 |
| 1942620059 | Katherine Morgan Wilson | Pediatrics | 3399 East Grand River Ave, Suite 200, Howell, MI 48843-7555 | 2014-04-16 |
| 1134440613 | Katherine L. Wilson | Psychologist | 5750 Sunrise Blvd Ste 130-f, Citrus Heights, CA 95610-7634 | 2010-06-18 |
| 1831334226 | Katherine Wilson | Behavioral Analyst | 1404 Beverly Dr, Richmond, VA 23229-4802 | 2008-12-13 |
| 1184884520 | Katherine Jones Wilson | Speech-Language Pathologist | 8338 Blades Trl, Denver, NC 28037-9154 | 2008-06-10 |
| 1598939654 | Katherine Mclean Wilson | Counselor | 110 Timber Creek Dr, Cordova, TN 38018-4279 | 2008-04-18 |
| 1750502159 | Katherine Dunn Wilson | Dentist | 74 State Rd Ste 102, Kittery, ME 03904-1562 | 2007-05-01 |
| 1811026099 | Katherine Wilson | Acupuncturist | 68 Paul Gore St, Jamaica Plain, MA 02130-1835 | 2007-03-05 |
| 1437246725 | Katherine De Koven Wilson | Marriage & Family Therapist | 1957 Pruneridge Avenue, Room 15, Santa Clara, CA 95050-6515 | 2006-10-06 |
| Street Address |
559 W TWINCOURT TRL UNIT 601 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32095-8805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285661736 | Traci L Bragg | Family Medicine | 559 W Twincourt Trl Unit 601, Credentialing Department, St Augustine, FL 32095-8805 | 2006-06-27 |
| 1366861981 | Heather D Nielsen | Family Medicine | 559 W Twincourt Trl Unit 601, St Augustine, FL 32095-8805 | 2014-04-10 |
| 1487855987 | Juan Carlos Fuentes | Family Medicine | 559 W Twincourt Trl Unit 601, Credentialing Department, St Augustine, FL 32095-8805 | 2007-05-30 |
| 1477635761 | Benjamin D Ernst | Family Medicine | 559 W Twincourt Trl Unit 601, St Augustine, FL 32095-8805 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124299201 | Dental Health Group PC | Dentist | 159 Palencia Village Drive, Ste 109, St. Augustine, FL 32095 | 2008-03-18 |
| 1932259405 | Thomas E Stakem | Dentist | 7175-01 U.S. Highway 17 South, Green Cove Springs, FL 32095 | 2007-01-10 |
| 1942390265 | Antonia Fuller | Registered Nurse | 354 Paseo Reyes Drive, Saint Augustine, FL 32095 | 2006-10-15 |
| 1740223023 | First Choice Phcy Svcs LLC | Pharmacy | 110 Cumberland Dr #305, St Augustine, FL 32095 | 2006-06-14 |
| 1174029201 | Aba Connection, LLC | Early Intervention Provider Agency | 23 Sol Ct, St Augustine, FL 32095 | 2018-04-05 |
| 1457437584 | Stanley A Cohen | Psychiatry & Neurology | 354 Paseo Reyes Drive, St Augustine, FL 32095 | 2006-10-31 |
| 1548576150 | Vicki Glabb | Counselor | 260 Ash Breeze Cv, Saint Augustine, FL 32095-0045 | 2010-08-20 |
| 1245770742 | Linda Gillis | Nurse Practitioner | 143 Portada Dr, St Augustine, FL 32095-1634 | 2017-03-02 |
| 1659821767 | Margo Slovis | Physical Therapist | 244 Vale Dr, St Augustine, FL 32095-4832 | 2016-10-12 |
| 1851909360 | Mammography Partners LLC | Clinic/Center | 521 Costa Del Sol Dr, St Augustine, FL 32095-4868 | 2020-07-21 |
| Find all providers in zip 32095 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114323490 | Neda Ruth Kadkhodaie | Physician Assistant | 2676 Us 1 S, St Augustine, FL 32086-6191 | 2014-11-13 |
| 1497021059 | Ralph David Priddy | Physician Assistant | 2305 State Road 207, St Augustine, FL 32086-9329 | 2012-03-28 |
| 1053685354 | Kristine Anderson Waters | Physician Assistant | 105 Southpark Blvd Ste A103, St Augustine, FL 32086-4162 | 2012-03-04 |
| 1437275880 | Richard A Oldano | Physician Assistant | 1300 Barrington Cir, St Augustine, FL 32092-3612 | 2007-03-21 |
| 1104978287 | Brent Davin Hopson | Physician Assistant | 3100 Us 1 S, St Augustine, FL 32086 | 2007-01-17 |
| 1538134721 | Jarrod D Roussel | Physician Assistant | 1 Orthopaedic Pl, St Augustine, FL 32086-4202 | 2006-02-21 |
| 1316946866 | Victoria O Miller | Physician Assistant | 493 Prosperity Lake Dr, St Augustine, FL 32092-5045 | 2005-07-18 |
| 1952912826 | Megan Burke | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2020-08-13 |
| 1508416991 | Ashley Jarriel Gucwa | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2019-09-17 |
| 1750804662 | Gabrielle Du Sablon | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-07-23 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32095 |
Please comment or provide details below to improve the information on MRS. KATHERINE ANN WILSON.
| 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.