Active NPI
Quintenda Lvett Wilson, NURSE
- Psychiatric/Mental Health Nurse Practitioner
- Sylvania, OH
National Provider Identifier
1336774231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- PN-102215
- Practice address
- 4038 Stonehenge Dr
Sylvania, OH 43560-3420 - Phone
- (502) 475-6231
- NPI assigned
- Mar 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | PN-102215 | OH | Primary |
Addresses
Primary practice location
4038 Stonehenge Dr
Sylvania, OH 43560-3420
Mailing address
4038 Stonehenge Dr
Sylvania, OH 43560-3420
Phone (502) 475-6231
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN-102215 | OH | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1336774231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4038 STONEHENGE DR",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435603420",
"telephone_number": "502-475-6231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4038 STONEHENGE DR",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435603420",
"telephone_number": "502-475-6231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "QUINTENDA",
"middle_name": "LVETT",
"credential": "NURSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-11",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OH",
"license": "PN-102215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylvania, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.