Katelyn Jeanne Wilson, PMHNP

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Phone

(505) 846-3305

NPI assigned

Apr 12, 2019

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

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1619430907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 HIGHLANDS PLAZA DR E APT 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101344",
            "telephone_number": "314-225-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-846-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATELYN",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Esse Wilson, MS CCC-SLP
• Joshua Wilson
• Joyce Elizabeth Wilson
• Kacee Jo Wilson, CNP
• Karen P. Wilson
• Katharine Wilson, RN, MSN, WHNP-BC
• Kourtney Wilson, LMHC
• Lawrence Woodrow Wilson, MD
• Lewis Era Earl Wilson, R.PH.
• Lisa Wilson, LMHC, PROVISIONAL

• Military Health Care Provider in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Military Health Care Provider in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.