Jasmine Wilson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043129842 Issued in IL

Practice address

416 Whitelaw Ave
Wood River, IL 62095-1509

Phone

(618) 741-0633

NPI assigned

Apr 3, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1821840844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 WHITELAW AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951509",
            "telephone_number": "618-741-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 WHITELAW AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951509",
            "telephone_number": "618-741-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JASMINE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043129842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co.
• Walmart Inc.
• Susan Lynn Way
• Barbara Well, BC-HIS
• Denise L West, LMSW
• Wood River Chiropractic, LLC
• Wood River Dental Group LLC
• Wood River Hartford SCH Dist 15
• Wood River Healthcare & Rehabilitation Center LLC
• Wood River NH LLC

• Licensed Practical Nurse in Wood River, IL
• Providers in Wood River, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.