LORETTA SUE WILSON (NPI# 1407002603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407002603 |
| Entity Type | Individual |
| Full Name | LORETTA SUE WILSON |
| Other Name | LORETTA SUE HENSLEY |
| Credential | N.P |
| Practice Address |
39 Cumberland Gap Plz Gray KY 40734-4536 |
| Mailing Address |
1019 Cumberland Falls Hwy Suite B201 Corbin KY 40701-2735 |
| Practice Telephone | 6065269005 |
| Practice Fax Number | 6065268606 |
| Mailing Telephone | 6065269005 |
| Mailing Fax Number | 6065268606 |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2018-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 3005770 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 1083291 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100089740 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421819 | Loretta Wilson | Peer Specialist | 3018 E 128th St, Cleveland, OH 44120-3003 | 2020-09-09 |
| 1780952580 | Loretta Eve Wilson | Nurse Practitioner | 700 Olympic Plaza Cir Ste 904, Tyler, TX 75701-1958 | 2011-12-07 |
| 1588917371 | Loretta J Wilson | Nurse Practitioner | 70 N Sturmer St, Belington, WV 26250 | 2012-10-18 |
| 1881968220 | Loretta L Wilson | Pharmacist | 3800 N Central Expy, Plano, TX 75074-2221 | 2012-03-02 |
| 1467750083 | Loretta Katherine Wilson | Clinical Nurse Specialist | 52 Dore St, San Francisco, CA 94103-3828 | 2011-03-06 |
| 1861450983 | Loretta K Wilson | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-05-01 |
| Street Address |
39 CUMBERLAND GAP PLZ |
| City | GRAY |
| State | KY |
| Zip Code | 40734-4536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346242641 | Knox County Family Practice Clinic, Inc. | Nurse Practitioner | 39 Cumberland Gap Plz, Ste 1, Gray, KY 40734-4536 | 2005-06-01 |
| 1396257358 | Rita Carol Gilbert | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2017-10-31 |
| 1447702659 | Angela Eversole | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2016-11-04 |
| 1194173203 | Sandra J Nantz | Psychologist | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2016-05-31 |
| 1457784159 | Veronica L Boley | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2013-08-16 |
| 1821439746 | Tammy S. Saylor | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2013-07-08 |
| 1396184255 | Mary Beth Lopez | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2013-06-24 |
| 1528407715 | Roberta L. York | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2013-06-20 |
| 1326380304 | Vernon Eugene Taylor Jr. | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2013-03-18 |
| 1699029462 | Crystal Ann Cooper | Nurse Practitioner | 39 Cumberland Gap Plz, Gray, KY 40734-4536 | 2012-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932622636 | Jessica Ashley Scearse | Specialist | 1892 Sam Parker Rd, Gray, KY 40734 | 2017-07-25 |
| 1043686561 | Ashley Barton | Nurse Practitioner | Us-25e Cumberland Gap Parkway, Gray, KY 40734 | 2015-08-19 |
| 1205905254 | Edna Eugenia Stewart | Nurse Practitioner | 39 Cumberland Gap Plaza, Gray, KY 40734-1401 | 2006-11-06 |
| 1801162672 | Superior Home Sleep Testing | Clinic/Center | 356 Highway 233, Gray, KY 40734-4504 | 2012-03-27 |
| 1174153514 | Redemption Road Recovery | Substance Abuse Rehabilitation Facility | 4222 Highway 830, Gray, KY 40734-4511 | 2020-01-24 |
| 1023105780 | Tammy L Freeman | Nurse Practitioner | 10755 N Us Highway 25e, Gray, KY 40734-6529 | 2006-10-06 |
| 1750557302 | Freeman Family Practice LLC | Nurse Practitioner | 10755 N Us Highway 25e, Gray, KY 40734-6529 | 2008-05-05 |
| 1477793818 | Erin Chadwell | Dietitian, Registered | 276 Woodlee Ln, Gray, KY 40734-6536 | 2009-02-25 |
| 1942717152 | Vickie Ann Mills | Nurse Practitioner | 147 Smith Hollow Rd, Gray, KY 40734-6574 | 2018-01-09 |
| 1689900896 | Melissa Garland | Health Educator | 5448 N Us Highway 25e, Gray, KY 40734-6582 | 2009-10-22 |
| Find all providers in zip 40734 | ||||
| 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 |
|---|---|---|---|---|
| 1821497942 | Providence Pediatrics, LLC | Nurse Practitioner | 140 Old Gray Station Road, Suite 200, Gray, TN 37615-3612 | 2014-08-14 |
| 1023105780 | Tammy L Freeman | Nurse Practitioner | 10755 N Us Highway 25e, Gray, KY 40734-6529 | 2006-10-06 |
| 1932155231 | Diane J Aubrey | Nurse Practitioner | 20 Ramsdell Rd, Gray, ME 04039-7757 | 2006-05-26 |
| 1346242641 | Knox County Family Practice Clinic, Inc. | Nurse Practitioner | 39 Cumberland Gap Plz, Ste 1, Gray, KY 40734-4536 | 2005-06-01 |
| 1134781073 | Michael Kelly | Nurse Practitioner | 1005 Boulder Dr, Gray, GA 31032-6141 | 2019-07-01 |
| 1972893139 | Melanie Dawn Davis | Nurse Practitioner | 115 Judge Gresham Rd, Suite B, Gray, TN 37615-6213 | 2011-04-08 |
| 1124339445 | Leslie Busbee Miller | Nurse Practitioner | 1005 Boulder Dr, Gray, GA 31032 | 2010-07-01 |
| 1528295078 | Calita Suzanne Hill | Nurse Practitioner | 1005 Boulder Dr, Gray, GA 31032 | 2009-06-11 |
| 1043402613 | Brenda Gail Tolleson | Nurse Practitioner | 1005 Boulder Dr, Gray, GA 31032 | 2007-08-16 |
| 1568488823 | Wendy Chartier | Nurse Practitioner | 115 Judge Gresham Rd, Suite B, Gray, TN 37615-6213 | 2006-07-13 |
| Find all providers in GRAY | ||||
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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.