Stacy A Wilson, FNP
Nurse Practitioner, Family in Vincennes, IN. Individual provider (NPI-1).
NPI number1982000568
StatusActive
Last updated in NPPESMar 11, 2024
Details
- NPI
- 1982000568
- Entity type
- Individual (NPI-1)
- Name
- Stacy A Wilson
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 10, 2014
- Certification date
- Mar 11, 2024
- Last updated
- Mar 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 71005227A | IN | Yes |
Other names
- Stacy A Johnson (Former Name)
Practice location
328 N 2nd St Ste 307Vincennes, IN 47591-1353
Phone 812-882-2703 · Fax 812-882-2760
Mailing address
1160 E Saint Clair StVincennes, IN 47591-4853
Phone 812-885-3325 · Fax 812-885-8987
Other practice locations
520 S 7th St
Vincennes, IN 47591-1038
Vincennes, IN 47591-1038
Phone 812-885-8770 · Fax 812-885-8771
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