Patrice Lavon Wilson, LPN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704406386 Issued in MI

Practice address

24759 Beach Dr
Macomb, MI 48042-4557

Phone

(313) 324-2300

NPI assigned

Sep 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1154091692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24759 BEACH DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424557",
            "telephone_number": "313-324-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24759 BEACH DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424557",
            "telephone_number": "313-324-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PATRICE",
        "middle_name": "LAVON",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703113331",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704406386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsie Wilbon, PT, DPT
• Samantha Wiles, BCBA
• Gwendolyn Wilhelm
• William Beauont Hospital
• Theresa Marie Williams, DC
• Phoebe Ann Wilson, M.D.
• Zabith Eli Wilson
• Kimberly Ann Winarski, RN, IBCLC
• Todd W Wohlfeil, DPT
• Michelle Wojie, PTA

• Registered Nurse in Macomb, MI
• Providers in Macomb, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.