Deoshanay Lamyia Wilson, DIPLOMA

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

00017004492063241086 Issued in NV

Practice address

4375 Boulder Hwy Apt 346
Las Vegas, NV 89121-3082

Phone

(702) 801-4438

NPI assigned

Oct 10, 2021

Last updated

Oct 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1633824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1588326284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 BOULDER HWY APT 346",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213082",
            "telephone_number": "702-801-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 BOULDER HWY APT 346",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213082",
            "telephone_number": "702-801-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEOSHANAY",
        "middle_name": "LAMYIA",
        "credential": "DIPLOMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-10",
        "last_updated": "2021-10-10",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "license": "2106451791",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "license": "00017004492063241086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VNV713796566",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Nichole Wilson
• Cozzetta Wilson
• Danielle Wilson
• Debbie Wilson
• Deirdre Wilson, MSW, IC-1758
• Devon Wilson
• Dezirae Wilson
• Dominic Wilson
• Dorothy Wilson
• Ekcho Wilson

• Personal Care Attendant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Personal Care Attendant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2021; 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.