KRISTEN MABUS WILSON CNP NPI 1831466747

NPI Information

NPI: 1831466747
Provider Name: KRISTEN MABUS WILSON, CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: SPARTANBURG MEDICAL CENTER

PECOS Registration: Yes

Address:
380 SERPENTINE DR
SUITE 200
SPARTANBURG, SC
ZIP 29303
Phone: (864) 560-7050
Get Directions

Kristen Mabus Wilson, CNP is a family nurse practitioner in Spartanburg, SC with 13 years of experience. Kristen Mabus Wilson, CNP NPI is 1831466747. 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:

380 SERPENTINE DR
SUITE 200
SPARTANBURG, SC
ZIP 29303-066
Phone: (864) 560-7050
Fax: (864) 560-0800

The NPI 1831466747 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, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/20/2011 and was last updated on 1/19/2021.

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	363LF0000X	Nurse Practitioner	Family	20205	SOUTH CAROLINA	Yes
2	363LF0000X	Nurse Practitioner	Family	TL20205	SOUTH CAROLINA	No
3	363LF0000X	Nurse Practitioner	Family	207724	NORTH CAROLINA	No
4	363LF0000X	Nurse Practitioner	Family	COA 15085 NP	OHIO	No

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	NP1954	MEDICAID	SOUTH CAROLINA
2	7005571	MEDICAID	NORTH CAROLINA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »