JACQUETTA NICOLE WILSON (NPI# 1265073985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265073985 |
| Entity Type | Individual |
| Full Name | JACQUETTA NICOLE WILSON |
| Credential | APRN |
| Practice Address |
3950 Kresge Way Ste 308 Louisville KY 40207-4637 |
| Mailing Address |
Po Box 9203 Belfast ME 04915-9203 |
| Practice Telephone | 5028958911 |
| Practice Fax Number | 5028958977 |
| Mailing Telephone | 5028959627 |
| Mailing Fax Number | 5028958977 |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2019-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 3013748 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3950 KRESGE WAY STE 308 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477545754 | John B Benton | Family Medicine | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2005-08-22 |
| 1346719804 | Katherine Medina | Nurse Practitioner | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2018-11-14 |
| 1104394246 | Leah Hughes | Registered Nurse | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2018-11-07 |
| 1053813303 | Allie English | Nurse Practitioner | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2018-03-02 |
| 1730696451 | Jennifer Haynes | Nurse Practitioner | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2018-01-03 |
| 1306380019 | Whitney Fallon | Nurse Practitioner | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2016-12-14 |
| 1235591249 | Perry Snyder | Internal Medicine | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2016-03-28 |
| 1407224470 | Elizabeth Miller | Nurse Practitioner | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2015-09-09 |
| 1568690162 | Stephen Matthew Furlow I | Internal Medicine | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2009-06-23 |
| 1477644151 | Michelle Diane Pisa | Internal Medicine | 3950 Kresge Way Ste 308, Louisville, KY 40207-4637 | 2006-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891645 | K Tierney Lanham LLC | Nurse Practitioner | 6431 Regency Ln, Louisville, KY 40207-2309 | 2020-11-06 |
| 1578192274 | Brian W Oliver | Nurse Practitioner | 309 Iola Rd, Louisville, KY 40207-2917 | 2020-04-04 |
| 1942835624 | Rebecca Spicer | Nurse Practitioner | 9805 Scarborough Ave, Louisville, KY 40272-2436 | 2020-03-03 |
| 1487288262 | Centerpointe Health LLC | Nurse Practitioner | 10100 Linn Station Rd, Louisville, KY 40223-3861 | 2020-03-02 |
| 1750914438 | Robin Elizabeth Masters | Nurse Practitioner | 2011 Lake Point Way Ste 202, Louisville, KY 40223-4229 | 2020-02-20 |
| 1629608286 | Meagan Molestina | Nurse Practitioner | 411 E Chestnut St # 4b6b, Louisville, KY 40202-1713 | 2020-01-23 |
| 1255971131 | Casey Lynn Potter | Nurse Practitioner | 411 Eaat Chestnut Street, Level 5a, Louisville, KY 40202-1713 | 2020-01-08 |
| 1487292033 | Norton Children's Medical Group, LLC | Nurse Practitioner | 1930 Bishop Ln Ste 101710, Louisville, KY 40218-1921 | 2019-12-13 |
| 1548803273 | Jessica L Withrow | Nurse Practitioner | 1900 Bluegrass Ave Ste 103, Louisville, KY 40215-1144 | 2019-10-25 |
| 1629627773 | Latonya Renee Banks | Nurse Practitioner | 2210 Buechel Avenue, Suite 105, Louisville, KY 40218-2619 | 2019-09-10 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
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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.