JUSTIN WILSON (NPI# 1417420704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417420704 |
| Entity Type | Individual |
| Full Name | JUSTIN WILSON |
| Credential | CRNP |
| Practice Address |
408 Clark St Ne Cullman AL 35055-1953 |
| Mailing Address |
503 Clark St Ne Cullman AL 35055-1921 |
| Practice Telephone | 2567343202 |
| Practice Fax Number | 2567344668 |
| Mailing Telephone | 2567390801 |
| Mailing Fax Number | 2567390027 |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2020-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-133787 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 241640 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1406 Wall St, Cullman, AL 350556011 | 2567362856 | 2567362867 |
| 1800 Al Highway 157, Cullman, AL 350581271 | 2567394131 | 2567396027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285021071 | Justin Alan Wilson | Specialist/Technologist, Other | 1015 E 32nd Street Suite 101, Austin, TX 78705 | 2015-04-20 |
| 1093138141 | Justin Adam Wilson | Registered Nurse | 2815 Sherbourne Ave, A, Nashville, TN 37204-2641 | 2014-01-27 |
| 1316249493 | Justin Andrew Wilson | Military Health Care Provider | 1st Marine Special Operations Battalion, Medical Department, Camp Pendleton, CA 92055-5341 | 2010-11-23 |
| 1447202098 | Justin Wilson | Physical Therapist | 1580 N Fiesta Blvd, Suite 102, Gilbert, AZ 85233-1032 | 2006-05-16 |
| 1831161850 | Justin B. Wilson | Internal Medicine | 59 Koch Ave, Morris Plains, NJ 07950-4400 | 2006-02-03 |
| 1861487340 | Justin Blake Wilson | Pharmacist | 1212a S Douglas Blvd, Midwest City, OK 73130-5213 | 2005-09-12 |
| 1275165615 | Justin Wilson | Counselor | 15544 S Clackamas River Dr, Oregon City, OR 97045-9490 | 2020-02-04 |
| 1679117428 | Justin Wilson | Chiropractor | 1637 S Market Blvd, Chehalis, WA 98532-3826 | 2019-11-05 |
| 1003472739 | Justin Wilson | Counselor | 3125 E 7th St, Long Beach, CA 90804-4932 | 2019-05-17 |
| 1801337944 | Justin K. Wilson | Nurse Practitioner | 201 Lyons Ave, Newark, NJ 07112-2027 | 2017-03-08 |
| Street Address |
408 CLARK ST NE |
| City | CULLMAN |
| State | AL |
| Zip Code | 35055-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780665703 | Angelia H Elliott | Family Medicine | 408 Clark St Ne, Cullman, AL 35055-1953 | 2005-11-08 |
| 1598284739 | Haley Elizabeth Mabrey | Family Medicine | 408 Clark St Ne, Cullman, AL 35055-1953 | 2017-09-19 |
| 1174063812 | Jamie Sims | Nurse Practitioner | 408 Clark St Ne, Cullman, AL 35055-1953 | 2017-02-28 |
| 1831562321 | Ashley Drake | Nurse Practitioner | 408 Clark St Ne, Cullman, AL 35055-1953 | 2015-11-05 |
| 1801212709 | Katherine Mann | Nurse Practitioner | 408 Clark St Ne, Cullman, AL 35055-1953 | 2014-03-16 |
| 1306192372 | David Edward Shupe | Family Medicine | 408 Clark St Ne, Cullman, AL 35055-1953 | 2012-07-27 |
| 1114238243 | Cullman Primary Care, PC | Family Medicine | 408 Clark St Ne, Cullman, AL 35055 | 2010-06-23 |
| 1801817523 | Randall L Quinn | Family Medicine | 408 Clark St Ne, Cullman, AL 35055-1953 | 2006-07-21 |
| 1043292055 | Sharon W Turner | Registered Nurse | 408 Clark St Ne, Cullman, AL 35055-1953 | 2005-11-16 |
| 1932180270 | Gregory L Meiman | Family Medicine | 408 Clark St Ne, Cullman, AL 35055-1953 | 2005-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013482694 | Timothy Brett Hunt | Counselor | 1912 Commerce Avenue Nw, Cullman, AL 35055 | 2018-10-10 |
| 1073017919 | Kaitlin Roberts | Occupational Therapist | 1640 2nd Ave Sw, Cullman, AL 35055 | 2018-03-23 |
| 1922514488 | Dialysis Clinic Inc | Clinic/Center | 208 Broadway Drive, Sw, Cullman, AL 35055 | 2017-12-20 |
| 1447789870 | Alexis Lindsey | Specialist | 1909 Commerce Avenue Nw, Cullman, AL 35055 | 2017-06-08 |
| 1003297144 | Thomas Ricky Cosper | Counselor | 1528 Peachtree Lane Ste #104, Cullman, AL 35055 | 2015-06-15 |
| 1053574434 | Joshua Michael Robinson | Dentist | 1851 Main Ave Se, Suite A, Cullman, AL 35055 | 2008-07-07 |
| 1902088206 | Dr Henry S Beeler | Family Medicine | 1900 Main Ave, Ste 3, Cullman, AL 35055 | 2007-11-29 |
| 1982896627 | Ronald Wilson Carter | Dentist | 305 6th Ave Se, Cullman, AL 35055 | 2007-08-16 |
| 1710048640 | Home Oxygen Inc | Durable Medical Equipment & Medical Supplies | 408 2nd Avenue Nw, Suite B, Cullman, AL 35055 | 2006-12-13 |
| 1912071150 | Econo Med Inc | Pharmacy | 1824 Main Avenue Sw, Cullman, AL 35055 | 2006-11-20 |
| Find all providers in zip 35055 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659906980 | Paige Makenzie Schnittker | Nurse Practitioner | 1958 Al-157, Cullman, AL 35058 | 2020-03-06 |
| 1447807334 | Nancy Elizabeth Alexander | Nurse Practitioner | 540 County Road 1526, Cullman, AL 35058-1650 | 2019-08-25 |
| 1235609124 | Jessica Peinhardt Rice | Nurse Practitioner | 1900 Main Ave Sw Ste 4, Cullman, AL 35055-7201 | 2018-12-04 |
| 1568966885 | Jacob Taylor | Nurse Practitioner | 1890 Al Highway 157 Ste 420b, Cullman, AL 35058-0689 | 2018-03-21 |
| 1659888261 | Stacy M Joiner | Nurse Practitioner | 1948 Al Highway 157 Ste 360, Cullman, AL 35058-0604 | 2018-01-04 |
| 1346683125 | Teri L Mobley | Nurse Practitioner | 2021 Alabama Hwy 157, Cullman, AL 35058 | 2013-04-11 |
| 1659464576 | Patricia Leann Calvert | Nurse Practitioner | 117 Second Ave Se, Cullman, AL 35055-3511 | 2006-10-02 |
| 1750310124 | Kimberly L Chaney | Nurse Practitioner | 1809 Kress St, Cullman, AL 35058-1565 | 2006-06-30 |
| 1629014352 | Rebecca Harris | Nurse Practitioner | 1890 Al Highway 157 Ste 300, Cullman, AL 35058-0689 | 2006-06-21 |
| 1952931735 | Jessica L Jordan | Nurse Practitioner | 1890 Al Highway 157 Ste 300, Cullman, AL 35058-0689 | 2020-01-22 |
| Find all providers in CULLMAN | ||||
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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.