Active NPI
Kourtney Lynn Wilson, NP
- Obstetrics & Gynecology Nurse Practitioner
- Fairfield, CA
National Provider Identifier
1780824912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- NP18844
- Practice address
- 2702 Low CT
Fairfield, CA 94534-9771 - Phone
- (707) 427-4900
- Fax
- (707) 432-2800
- NPI assigned
- Feb 27, 2009
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | NP18844 | CA | Primary |
Addresses
Primary practice location
2702 Low CT
Fairfield, CA 94534-9771
Mailing address
2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 427-4900
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP18844 | CA | MD | Obstetrics & Gynecology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235692800000",
"number": "1780824912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2702 LOW CT",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945349771",
"telephone_number": "707-427-4900",
"fax_number": "707-432-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2702 LOW CT",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945349771",
"telephone_number": "707-427-4900",
"fax_number": "707-432-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KOURTNEY",
"middle_name": "LYNN",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-27",
"last_updated": "2009-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "CA",
"license": "NP18844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.