Carolyn Lorraine Wilson

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

3332772 Issued in FL

Practice address

349 NW 30TH Ave
Ft Lauderdale, FL 33311-8427

Phone

(954) 696-6243

NPI assigned

Mar 10, 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

Other identifiers 1

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": "1552176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552176000000",
    "number": "1619435518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 NW 30TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333118427",
            "telephone_number": "954-696-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 NW 30TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333118427",
            "telephone_number": "954-696-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAROLYN",
        "middle_name": "LORRAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-10",
        "last_updated": "2019-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "FL",
            "license": "3332772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "3332772",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Lytle Willis, A.R.N.P.
• Brian Wilner, D.C.
• Erica Wilner
• Jarrod Scott Wilner, D.C.
• Ashley Lynn Wilson, PT, DPT
• Hope Wilson
• Jarrod Wilson
• Robert Wayne Wilson, MD
• Tammie Monique Wilson
• Leonie Wims, L.AC.

• Medical-Surgical Registered Nurse in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Medical-Surgical Registered Nurse in Florida

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