Stephanie Wilson, LVN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

219438 Issued in TX

Practice address

2701 Cumberland Rd
Odessa, TX 79762-6913

Phone

(951) 413-9638

NPI assigned

Jun 10, 2020

Last updated

Jun 10, 2020By the provider in NPPES

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1346865888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 CUMBERLAND RD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797626913",
            "telephone_number": "951-413-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CUMBERLAND RD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797626913",
            "telephone_number": "951-413-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHANIE",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "219438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Barry Willingham, M.D.
• Jack K Willis Jr., PA
• Marta Gay Willoughby, MD
• Erin Wilson, MD
• Lloyd Austin Wilson, MA, LPC
• Joshua Caine Wimberley, NRP
• Windham Pyschiatry P.C.
• Sandra Nicole Windham, PMHNP-BC
• Stephanie Marie Windisch, MBA, LMSW
• Lori Jo Wingate, APRN-BC

• Licensed Practical Nurse in Odessa, TX
• Providers in Odessa, TX by specialty
• Licensed Practical Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.