Lisa Ruth Wilson, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2014010130 Issued in MO

Practice address

324 W 5TH St
Washington, MO 63090-2306

Phone

(636) 795-0342

NPI assigned

Apr 16, 2014

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1710307889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24776 STATE HIGHWAY EE",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633835883",
            "telephone_number": "636-795-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902306",
            "telephone_number": "636-795-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LISA",
        "middle_name": "RUTH",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2014010130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter G Wienke, M.D.
• Sarah Jo Wildt, LCSW
• Christin Chanel Wilkinson, MD
• Jane Ellen Williams, BACHELORS OF SCIENCE
• Emmalee Willimann, PTA
• Colleen Marie Wingate, DO
• Ashley R. Wisdom, LPC
• Megan Rochelle Wood, PMHNP
• Michael Leonard Wood, MD
• Alissa Wooden, RD

• Adult Health Nurse Practitioner in Washington, MO
• Providers in Washington, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.