Active NPI
Stacey Lynn Wilson, FNP-BC
- Family Nurse Practitioner
- Wesley, AR
National Provider Identifier
1760911176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2017006269
- Practice address
- 226 Madison 7875
Wesley, AR 72773 - Phone
- (479) 790-9308
- NPI assigned
- Jun 8, 2017
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2017006269 | AR | Primary |
Addresses
Primary practice location
226 Madison 7875
Wesley, AR 72773
Mailing address
226 Madison 7875
Wesley, AR 72773-8615
Phone (479) 790-9308
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 |
|---|---|---|---|
| 2017006269 | AR | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1760911176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 MADISON 7875",
"city": "WESLEY",
"state": "AR",
"postal_code": "727738615",
"telephone_number": "479-790-9308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 MADISON 7875",
"city": "WESLEY",
"state": "AR",
"postal_code": "72773",
"telephone_number": "479-790-9308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STACEY",
"middle_name": "LYNN",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "2017006269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.