Active NPI
Tanya Wilson
- Licensed Practical Nurse
- Independence, MO
National Provider Identifier
1710788013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 2006039334
- Practice address
- 3205 N Twyman Rd
Independence, MO 64058-3212 - Phone
- (816) 708-0768
- NPI assigned
- Mar 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 2006039334 | MO | Primary |
Addresses
Primary practice location
3205 N Twyman Rd
Independence, MO 64058-3212
Mailing address
5500 Ming Ave Ste 265
Bakersfield, CA 93309-4696
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006039334 | MO | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742601600000",
"number": "1710788013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 MING AVE STE 265",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933094696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3205 N TWYMAN RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640583212",
"telephone_number": "816-708-0768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TANYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-22",
"last_updated": "2025-03-22",
"certification_date": "2025-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MO",
"license": "2006039334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.