Carol Mitchell Wilson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R069925 Issued in AR

Practice address

745 Old Warren Rd
Monticello, AR 71655-9713

Phone

(870) 460-7445

NPI assigned

Apr 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1598721417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MASONVILLE RD",
            "city": "MC GEHEE",
            "state": "AR",
            "postal_code": "716549795",
            "telephone_number": "870-222-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 OLD WARREN RD",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716559713",
            "telephone_number": "870-460-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAROL",
        "middle_name": "MITCHELL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "AR",
            "license": "R69925",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AR",
            "license": "R69925",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R069925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keely Shaye Williams
• Latisha M Williams
• Tylaria Williams
• William W Williams, DO
• Alan Kirk Wilson, M.D.
• Heather Michelle Wilson, DPP LIFESTYLE COACH
• Nancy Michelle Wilson
• Tianna Wilson
• Tywana Wilson
• Joshua Daniel Wood, LPC

• Registered Nurse in Monticello, AR
• Providers in Monticello, AR by specialty
• Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.