Elizabeth L. Wilson, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN191733 Issued in GA

Practice address

215 12TH St W
Tifton, GA 31794-3923

Phone

(229) 396-5335

Fax

(229) 396-5330

NPI assigned

Mar 16, 2012

Last updated

Apr 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624
  Medicare reassignment NPD
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Sylvester, GA
  • NPI 1811874696
  NPD
• Tiftarea Pediatrics

  • Pediatrics Physician
  • Tifton, GA
  • NPI 1154081271
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1093080541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 12TH ST W",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943923",
            "telephone_number": "229-396-5335",
            "fax_number": "229-396-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 12TH ST W",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943923",
            "telephone_number": "229-396-5335",
            "fax_number": "229-396-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELIZABETH",
        "middle_name": "L.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-16",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN191733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA MEDICAL LICENSE",
            "identifier": "RN191733",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kory Shanese Williams
• Lakesha A Williams, NP
• Raven Jacole Williams
• Pamela Kay Willingham, NP
• Jessica Ally Wilson Atkins, ATC, LAT, DPT
• Kimberly Dawn Wilson, M.ED., CCC-SLP
• Mark Davis Wilson, M.D.
• Michael Scot Wilson, R.PH.
• Amanda Caroline Wimberley, RN
• Amber Wingate, NP

• Pediatric Nurse Practitioner in Tifton, GA
• Providers in Tifton, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.