Wilmalean Michelle Black, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12361U4 Issued in MS

Practice address

2506 39TH St Apt 68
Meridian, MS 39305-3887

Phone

(601) 850-1012

NPI assigned

Jan 30, 2024

Last updated

Mar 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lifeline Diagnostic

  • Community Health Worker
  • Meridian, MS
  • NPI 1558131722
  NPD Authorized official
• Lifeline Diagnostics Co

  • Home Health Agency
  • Meridian, MS
  • NPI 1912705989
  NPD Authorized official

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1114789658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 39TH ST APT 68",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393053887",
            "telephone_number": "601-850-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 39TH ST APT 68",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393053887",
            "telephone_number": "601-850-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "WILMALEAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "12361U4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Bevill, D.O.
• Sana L Bhatti, M.D.
• Bo Bilello
• William A Billups III, M.D.
• Garrett Black
• Alyse Blackwell, DPT
• John R Blackwell, M.D.
• Taylor Renee Blackwell, DNP, AGACNP-BC
• Kendra Blakely, MS, LPC, NCC
• Amanda Christine Blount, LPC

• Nurse Practitioner in Meridian, MS
• Providers in Meridian, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.