Emily Marie Reba Wilson

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

330058 Issued in AZ

Practice address

1834 N 208TH Ave
Buckeye, AZ 85396-5488

Phone

(703) 300-4245

NPI assigned

Oct 14, 2025

Last updated

Oct 14, 2025By the provider in NPPES

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

Other names 1

• Emily Marie Reba Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scottsdale Pediatrics and Pediatric Nephrology, PLLC

  dba Agave Pediatrics

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1629076518
  NPD (past)

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1770459968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 N 208TH AVE",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853965488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 N 208TH AVE",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853965488",
            "telephone_number": "703-300-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "EMILY",
        "middle_name": "MARIE REBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "330058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "REBA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Marie Williams, LPN
• Patrick Taylor Williams
• Shelbie Nichole Williams, FNP
• Analycia Wilson
• Donna Wilson
• Oginga Wilson
• Wremaine Lumass Dupree Wilson, DDS
• Tresenia Monice Womack, LAMFT
• Michelle Woods
• Elizabeth Work

• Primary Care Nurse Practitioner in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.