Individual provider Active NPI

Yolanda L Wilson, RN, FNP-BC

  • Family Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1891059309
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN179299 Issued in GA
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(770) 680-9644
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN179299 GA Primary
Registered Nurse 163W00000X RN179299 GA

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

3187 Krisam Creek Dr
Loganville, GA 30052-7915
Phone (678) 478-4391

Other practice location 1

2140 Rockbridge Rd Ste 107
Stone Mountain, GA 30087-3507
Phone (678) 598-0883

Other practice location 2

1370 Montreal Rd
Suite 170
Tucker, GA 30084-8188
Phone (770) 621-0870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116002267 GA Practitioner - Nurse Practitioner 1759868060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN179299GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Dec 14, 2025 Accepting new patients
Charlotte Web Private Home Care, LLC PastSince Mar 12, 2023 Accepting new patients

Locations

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 891-9833

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1891059309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3187 KRISAM CREEK DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527915",
            "telephone_number": "678-478-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "770-680-9644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2140 Rockbridge Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Stone Mountain",
            "state": "GA",
            "postal_code": "300873507",
            "country_code": "US",
            "telephone_number": "678-598-0883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1370 Montreal Rd",
            "address_2": "Suite 170",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300848188",
            "country_code": "US",
            "telephone_number": "770-621-0870",
            "fax_number": "770-621-9518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "YOLANDA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN179299",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN179299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.