Victoria Nichole Wilson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1409 Jacqualine Street
Logansport, LA 71049

Phone

(318) 575-9018

NPI assigned

Dec 30, 2021

Last updated

Dec 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1730849852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1041",
            "city": "LOGANSPORT",
            "state": "LA",
            "postal_code": "710491041",
            "telephone_number": "318-575-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 JACQUALINE STREET",
            "city": "LOGANSPORT",
            "state": "LA",
            "postal_code": "71049",
            "telephone_number": "318-575-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VICTORIA",
        "middle_name": "NICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Sistrunk Richardson, FNPC
• Octavia Paulette Richardson
• Felicia W Ross, LPN
• Shomichael Stephens, PHARMD
• Robert Edwin Toner III, PA-C
• Francie Louann Woods

• Community Health Worker in Logansport, LA
• Providers in Logansport, LA by specialty
• Community Health Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.