Individual provider Active NPI

Krysten Henage Wilson, FNP-C

  • Family Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1679423925
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-164626 Issued in AL
Practice address
1924K Dauphin Island Pkwy
Mobile, AL 36605-3004
Phone
(251) 308-9800
NPI assigned
Jan 28, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-164626 AL Primary

Addresses

Primary practice location

1924K Dauphin Island Pkwy
Mobile, AL 36605-3004

Mailing address

1130 Forest Ave
Saraland, AL 36571-9618
Phone (251) 513-0981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260211002013 AL Practitioner - Nurse Practitioner 5193204949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

210 S Main St
Crestview, FL 32536-3737

930 Mar Walt Dr Unit C
Fort Walton Beach, FL 32547-3254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-164626ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Pain & Wellness LLC CurrentSince Mar 2, 2026 Accepting new patients
Dynamic Pain & Wellness LLC CurrentSince Mar 2, 2026 Accepting new patients

Locations

1924K Dauphin Island Pkwy
Mobile, AL 36605
Phone (251) 308-9800

210 S Main St
Crestview, FL 32536
Phone (850) 306-3433

930 Mar Walt Dr
Unit C
Fort Walton Beach, FL 32547
Phone (850) 431-6183

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1679423925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 FOREST AVE",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365719618",
            "telephone_number": "251-513-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924K DAUPHIN ISLAND PKWY",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366053004",
            "telephone_number": "251-308-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRYSTEN",
        "middle_name": "HENAGE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-164626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.