Individual provider · Type 1 NPI

Emily Jean Wilson, AGNP-C

Gerontology Nurse Practitioner · Grand Rapids, MI

NPI number 1083599740 Active

Practice location

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Call (616) 685-5050 Map

Mailing address

4164 Singel Dr SW
Grandville, MI 49418-2324

Specialties and licenses

Taxonomy	Code	License
Gerontology Nurse Practitioner Primary	363LG0600X	4704225570 (MI)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1083599740

Emily Jean Wilson, AGNP-C's National Provider Identifier is 1083599740, issued on Aug 11, 2025. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Grand Rapids, MI. The record was last updated on Aug 11, 2025.