Brian A Wilson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95205412 Issued in CA

Practice address

12801 Brookhurst St Unit 1118
Garden Grove, CA 92840-4864

Phone

(843) 214-5783

NPI assigned

Dec 31, 2019

Sex

Male

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

Credentials

Doctor of Medicine, Registered Nurse

State licenses

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1770122269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12801 BROOKHURST ST UNIT 1118",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404864",
            "telephone_number": "843-214-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 BROOKHURST ST UNIT 1118",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404864",
            "telephone_number": "843-214-5783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Victoria St",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926271995",
            "country_code": "US",
            "telephone_number": "949-642-2734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95205412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Williams
• Nicole Williams
• Stanford Lee Williams
• Trevor Williams
• Waylon Williams
• David Wilson
• Dalaney Windom
• Windstone Behavioral Health
• Cynthia Wineinger, SLP
• Christopher R Winkle, MD

• Registered Nurse in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.