Individual provider Active NPI

Amy Michelle Wilke, RN

  • Nutrition Support Registered Nurse
  • Carlsbad, CA
National Provider Identifier
1295547966
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support Registered NurseTaxonomy code 163WN1003X
License
675894 Issued in CA
Practice address
6813 Jade LN
Carlsbad, CA 92009-1717
Phone
(858) 335-4708
NPI assigned
Jan 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Registered Nurse 163WN1003X 675894 CA Primary

Addresses

Primary practice location

6813 Jade LN
Carlsbad, CA 92009-1717

Mailing address

6813 Jade LN
Carlsbad, CA 92009-1717
Phone (858) 335-4708

Other names 1

  • Amy Michelle Kiley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
675894CAMDNutrition Support Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1295547966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6813 JADE LN",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920091717",
            "telephone_number": "858-335-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6813 JADE LN",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920091717",
            "telephone_number": "858-335-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "CA",
            "license": "675894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "KILEY",
            "middle_name": "MICHELLE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.