Ambra Lynn Wilson, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

23927 Issued in TN

Practice address

275 Walton Dr
Waverly, TN 37185-3382

Phone

(931) 296-9984

Fax

(931) 296-1935

NPI assigned

Mar 20, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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 and National Provider Directory roles.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Waverly, TN
  • NPI 1073530267
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1154825669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 WALTON DR",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371853382",
            "telephone_number": "931-296-9984",
            "fax_number": "931-296-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 WALTON DR",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371853382",
            "telephone_number": "931-296-9984",
            "fax_number": "931-296-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMBRA",
        "middle_name": "LYNN",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "23927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waverly Pediatric and Adult Care
• Waverly SNF Healthcare LLC
• Wayland Alva Brooks
• Angelique Marie Wilcox, OTR/L, OTD
• Anneliese Wilsdorf, PA-C
• Melanie Worden, COTA/L
• Merinda Lynn Young, LCSW
• Kristie Zimmerman, NP

• All providers in Waverly, TN
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.