PROF. JULIE M WILSON PH.D. NPI 1497789069

NPI Information

NPI: 1497789069
Provider Name: PROF. JULIE M WILSON, PH.D.
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
111 BREWSTER ST
PAWTUCKET, RI
ZIP 02860
Phone: (401) 729-6200
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PROF. Julie M Wilson, PH.D. is a pediatrics nurse practitioner in Pawtucket, RI. PROF. Julie M Wilson, PH.D. NPI is 1497789069. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

111 BREWSTER ST
PAWTUCKET, RI
ZIP 02860-474
Phone: (401) 729-6200
Fax: (401) 729-6203

The NPI 1497789069 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 1/27/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist		PS00582	RHODE ISLAND	No
2	363L00000X	Nurse Practitioner		PS00582	RHODE ISLAND	No
3	363LP0200X	Nurse Practitioner	Pediatrics	APRN00315	RHODE ISLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	25670-4	OTHER	RHODE ISLAND	BLUE CROSS/BLUE SHIELD
2	410199	OTHER	RHODE ISLAND	BLUECHIP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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