MRS. DIANE BROADY WILSON (NPI# 1881605665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881605665 |
| Entity Type | Individual |
| Full Name | MRS. DIANE BROADY WILSON |
| Other Name | MS. DIANE O'MEARA BROADY |
| Credential | LPC |
| Practice Address |
1411 E Amarillo Blvd 1411 Amarillo Blvd., East, J.o. Wyatt Clinic Amarillo TX 79107-5555 |
| Practice Telephone | 8063517212 |
| Practice Fax Number | 8063517284 |
| Mailing Telephone | 8063517212 |
| Mailing Fax Number | 8063517284 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
16692 | TX | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 144810202 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184141632 | Diane M. Wilson | Counselor | 205 School St. #202, Gardner, MA 01440 | 2017-08-25 |
| 1013219708 | Diane Wilson | Occupational Therapy Assistant | 15 Palmer Ct, Maybrook, NY 12543-1126 | 2010-12-01 |
| 1821229188 | Diane Grimard Wilson | Counselor | 333 W Wacker Dr Ste 500, Chicago, IL 60606-1225 | 2009-08-05 |
| 1821295049 | Diane Alice Wilson | Mechanotherapist | 307 N Pineview St, Stanberry, MO 64489-1509 | 2007-06-29 |
| 1285731711 | Diane Orsak Wilson | Nurse Practitioner | 508 Desert Lakes Rd., Alamogordo, NM 88310 | 2006-09-19 |
| 1013013259 | Diane H. Wilson | Counselor | 9212 Fairlane Pl, Laurel, MD 20708-2860 | 2006-09-15 |
| 1013932185 | Diane Eh Wilson | Family Medicine | 1937 W 5700 S, Roy, UT 84067-2303 | 2006-07-12 |
| 1841236635 | Diane G Wilson | Optometrist | 1235 Water Tower Pl, Arnold, MO 63010-2142 | 2006-06-21 |
| 1619969805 | Diane D Wilson | Nurse Anesthetist, Certified Registered | 3000 Herring Ave, Waco, TX 76708-3239 | 2005-08-16 |
| 1578124996 | Diane Marie Wilson | Counselor | 225 Margaret Ave Ste 3, Jeannette, PA 15644-3081 | 2019-06-26 |
| Street Address |
1411 E AMARILLO BLVD 1411 AMARILLO BLVD., EAST, J.O. WYATT CLINIC |
| City | AMARILLO |
| State | TX |
| Zip Code | 79107-5555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396726212 | Jeffrey S Pickens | Family Medicine | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2005-11-08 |
| 1760030100 | Jennifer Kathryn Ebeling | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-08-29 |
| 1073175154 | Todd M Walls | Pharmacist | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-06-28 |
| 1245796911 | William Bowman | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-02-18 |
| 1427523737 | Meredith Mercer | Pharmacist | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2018-10-12 |
| 1043766272 | Blanca Rangel | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2016-08-28 |
| 1063863314 | Brandi Lehning | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2016-06-28 |
| 1770903304 | Whitney L Dowd | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2014-04-22 |
| 1780008904 | Northwest Texas Wyatt Clinic Pllc | Family Medicine | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2014-02-07 |
| 1578998951 | Cecelia Garcia Brewer | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2013-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851738884 | Daniel J Meadors | Dentist | 2201 N. Grand, Amarillo, TX 79107 | 2013-05-31 |
| 1568660785 | Keelie Nicole Hauk | Dental Hygienist | 850 Martin Road, Amarillo, TX 79107 | 2007-07-10 |
| 1346361664 | Daniel J Meadors Dds Inc | Dentist | 2201 N Grand, Amarillo, TX 79107 | 2007-04-03 |
| 1881701795 | John C Curry | Dentist | 2201 N Grand St, Amarillo, TX 79107 | 2006-08-24 |
| 1285633305 | Kathy Ann Ford | Nurse Practitioner | 824 Martin Rd, Amarillo, TX 79107 | 2005-07-20 |
| 1629572854 | Ihnbae Cho | Dentist | 206 Ne 7th Ave, Amarillo, TX 79107 | 2018-03-21 |
| 1467736363 | Maria Fernanda Contreras | Pediatrics | 713 N Taylor St, Amarillo, TX 79107 | 2011-10-11 |
| 1477735322 | Timothy John Revell | Emergency Medicine | 9601 Spur 591, Amarillo, TX 79107 | 2007-12-03 |
| 1851309280 | John Michael Archer | Dentist | 1900 Coulter Road, Suite G, Amarillo, TX 79107-1732 | 2006-08-03 |
| 1386067593 | Amber Leigh Roth | Nurse Practitioner | 1411 East Amarillo Blvd, Amarillo, TX 79107-1770 | 2014-01-23 |
| Find all providers in zip 79107 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811508286 | Mark Harris | Counselor | 6120 Rutgers St, Amarillo, TX 79109-6615 | 2020-08-11 |
| 1003455098 | Pamela Dawn George | Counselor | 3807 S. Virginia, Amarillo, TX 79109 | 2019-12-23 |
| 1194382671 | Chiffon Melissa Samuel | Counselor | 705 S Grant St Unit 14, Amarillo, TX 79101-2514 | 2019-05-21 |
| 1134691017 | Linda Darlene Podzemny | Counselor | 5250 Cliffside Road, Amarillo, TX 79124 | 2018-12-17 |
| 1720491913 | Kimberley Sterling | Counselor | 1616 S Kentucky St Ste C220, Amarillo, TX 79102-2290 | 2014-06-05 |
| 1134554462 | Amanda L. Durst | Counselor | 7470 Golden Pond Pl, Suite 300, Amarillo, TX 79121-1997 | 2013-09-05 |
| 1093060998 | Kristy Paddack Counseling Pllc | Counselor | 4300 Teckla Blvd, Suite 3b, Amarillo, TX 79109-5494 | 2012-07-17 |
| 1689975294 | Jeffery Alan Kee | Counselor | 3306 Bedford Rd, Amarillo, TX 79106-2906 | 2010-11-12 |
| 1750531117 | Clara Valdez | Counselor | 6010 W. Amarillo Blvd., Amarillo, TX 79106 | 2008-09-23 |
| 1902070360 | William Charles Santer IIi | Counselor | 3414 Olsen Blvd, Suite E, Amarillo, TX 79109-3072 | 2008-04-16 |
| Find all providers in AMARILLO | ||||
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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.