Keisha Lyn Wilson

Primary specialty

Oncology Registered NurseTaxonomy code 163WX0200X

License

5161770 Issued in ID

Practice address

778 Regency LN
Idaho Falls, ID 83402-1278

Phone

(208) 520-1890

NPI assigned

Nov 4, 2026

Last updated

Nov 4, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1793750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793750400000",
    "number": "1588563548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 REGENCY LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834021278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 REGENCY LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834021278",
            "telephone_number": "208-520-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KEISHA",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-11-04",
        "last_updated": "2026-11-04",
        "certification_date": "2026-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "ID",
            "license": "5161770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willow Creek Dental PC
• Willow Sage Services LLC
• Bridgette Wilson, PHARMD
• David Earl Wilson, D.D.S
• Emily Wilson
• Millie Wilson
• Nichole Chauntelle Wilson
• William P.D. Wilson III, M.D.
• Angela Winchester
• David Winchester, FNP

• Oncology Registered Nurse in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Oncology Registered Nurse in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.