Individual provider · Type 1 NPI

Javda Miasha Wilson, FNP

Nurse Practitioner · Florissant, MO

NPI number 1124459730 Active

Practice location

1225 Graham Rd, Dept Emergency Medicine
Florissant, MO 63031-8012

Fax (314) 747-9160

Mailing address

PO Box 7412011
Chicago, IL 60674-2011

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X2013043631 (MO)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1124459730

Javda Miasha Wilson, FNP's National Provider Identifier is 1124459730, issued on Dec 6, 2013. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Florissant, MO. The record was last updated on Jul 14, 2025.