Penny Laine Wilson

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD10308 Issued in AR

Practice address

2252 N 8TH St
Rogers, AR 72756-2842

Phone

(479) 621-9188

NPI assigned

Dec 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Penny Laine Brown Former name

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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1700481249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 PARK RIDGE WAY",
            "city": "CAVE SPRINGS",
            "state": "AR",
            "postal_code": "727188443",
            "telephone_number": "479-381-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2252 N 8TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727562842",
            "telephone_number": "479-621-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PENNY",
        "middle_name": "LAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2018037540",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD10308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "BROWN",
            "middle_name": "LAINE",
            "credential": "PHARM. D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Brian Wilson II
• Elizabeth A Wilson, APRN-CNP
• Eric Wilson
• Janice Lynn Wilson
• Jason Scott Wilson
• Victoria Ann Wilson, MS CCC-SLP
• Jackson Wimberly
• Jacob A Wingfield, PHARMD
• Shayla Winkel
• Ashley Jo Winsemius-Hackney, PTA

• Pharmacist in Rogers, AR
• Providers in Rogers, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.