KELLY LYNN WILSON NPI 1710290184

NPI Information

  • NPI: 1710290184
  • Provider Name: KELLY LYNN WILSON
  • Classification: Speech-Language Pathologist - 235Z00000X
  • Entity Type: Individual
  • Address: 6600 VAN AALST BLVD BLDG 9250
    FORT MOORE, GA
    ZIP 31905
  • Phone: (706) 545-7308

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NPI Details

Kelly Lynn Wilson is a speech language pathologist in Fort Moore, GA. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. Kelly Lynn Wilson NPI is 1710290184. 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:

6600 VAN AALST BLVD BLDG 9250
FORT MOORE, GA
ZIP 31905-102
Phone: (706) 545-7308

The enumeration date for this NPI number is 7/14/2010 and was last updated on 12/13/2023.

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
1235Z00000XSpeech-Language PathologistSA13784FLORIDAYes

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
180S945OTHERTEXASBLUE CROSS BLUE SHIELD
2214307501MEDICAIDTEXAS

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: 11/21/2025

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