Jill Nicole Wilson, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

5140356-4405 Issued in UT

Practice address

5121 Cottonwood St
Murray, UT 84107-5701

Phone

(801) 507-6400

Fax

(801) 507-6491

NPI assigned

Nov 15, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Liberty Dialysis-Woods Cross LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Woods Cross, UT
  • NPI 1396924957
  NPD (past)

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1811274095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 W 820 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011471",
            "telephone_number": "801-368-3968",
            "fax_number": "801-377-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-6400",
            "fax_number": "801-507-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JILL",
        "middle_name": "NICOLE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "5140356-8900",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "5140356-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Williamson, LCSW
• Duncan Peter Williamson, PT, DPT
• Lance David Willingham, PT
• Willis Plastic Surgery LLC
• Byron Wilson
• Kelsie Lee Wilson
• Melissa Wilson, COTA
• Sakina Wilson
• Teya C Wilson
• Jeremy Paul Wimmer, D.C.

• Acute Care Nurse Practitioner in Murray, UT
• Providers in Murray, UT by specialty
• Acute Care Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.