Quinterria Tenicia Wilson

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

RN268795 Issued in GA

Practice address

1110 Malone Ferguson Rd
Garnett, SC 29922-5806

Phone

(803) 842-7163

NPI assigned

Sep 7, 2020

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

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1154935153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 MALONE FERGUSON RD",
            "city": "GARNETT",
            "state": "SC",
            "postal_code": "299225806",
            "telephone_number": "803-842-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 MALONE FERGUSON RD",
            "city": "GARNETT",
            "state": "SC",
            "postal_code": "299225806",
            "telephone_number": "803-842-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "QUINTERRIA",
        "middle_name": "TENICIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "RN268795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Renee David
• Tarina Tameka Englrum, CCMA

• Community Health Registered Nurse in Garnett, SC
• Providers in Garnett, SC by specialty
• Community Health Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2020; 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.