SARAH KATHERINE KIMBLE WILSON CNP NPI 1235403874

NPI Information

NPI: 1235403874
Provider Name: SARAH KATHERINE KIMBLE WILSON, CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4500 13TH ST
GULFPORT, MS
ZIP 39501
Phone: (228) 575-2676
Get Directions

Sarah Katherine Kimble Wilson, CNP is a family nurse practitioner in Gulfport, MS. Sarah Katherine Kimble Wilson, CNP NPI is 1235403874. 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:

4500 13TH ST
GULFPORT, MS
ZIP 39501-515
Phone: (228) 575-2676
Fax: (228) 864-7415

The NPI 1235403874 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 2/29/2012 and was last updated on 2/21/2018.

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	R866933	MISSISSIPPI	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	09221069	MEDICAID	MISSISSIPPI
2	30250I4396	OTHER	MISSISSIPPI	MEDICARE
3	9740799	OTHER	MISSISSIPPI	AETNA
4	3431557	OTHER	MISSISSIPPI	UHC
5	5799138	OTHER	MISSISSIPPI	CIGNA

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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