Amanda Marie Wilson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704280384 Issued in MI

Practice address

1040 S Winter St
Suite 1022
Adrian, MI 49221-3876

Phone

(517) 263-8905

NPI assigned

Aug 21, 2012

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

Other names 1

• Amanda Marie Crawford Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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 and National Provider Directory roles.

• Lenawee Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Adrian, MI
  • NPI 1912227570
  NPD (past)
• Lenawee Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Adrian, MI
  • NPI 1962576983
  NPD (past)

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1801144092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "address_2": "SUITE 1022",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "address_2": "SUITE 1022",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876",
            "telephone_number": "517-263-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704280384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CRAWFORD",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wheelock Pharmacy, Inc
• Janis Whitehead
• Jessica Lynn Willnow
• Casandra Jean Willoughby
• Willow and Sage
• Caitlin Jean Wilson, LMT
• Gabriela Cristina Wilson, NP
• Timothy Douglas Wing
• Melissa Ann Winkler, LMSW
• Julia Lyn Winser

• Registered Nurse in Adrian, MI
• Providers in Adrian, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.