Individual provider Active NPI

Jennifer Lynn Wilson, CRNP

  • Critical Care Neonatal Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1619951464
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
R115360 Issued in MD
Practice address
600 N Wolfe St
CMCS 2 - Nicu
Baltimore, MD 21287-0005
Phone
(410) 955-5255
Fax
(410) 614-8834
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X R115360 MD
Critical Care Neonatal Nurse Practitioner 363LN0005X R115360 MD Primary

Addresses

Primary practice location

600 N Wolfe St
CMCS 2 - Nicu
Baltimore, MD 21287-0005

Mailing address

616 Emerson PL
Severna Park, MD 21146-3410
Phone (410) 544-4349

Other names 1

  • Ms. Jennifer Wilson Keller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1619951464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 EMERSON PL",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463410",
            "telephone_number": "410-544-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "CMCS 2 - NICU",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-5255",
            "fax_number": "410-614-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MD",
            "license": "R115360",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MD",
            "license": "R115360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KELLER",
            "middle_name": "WILSON",
            "prefix": "MS.",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.