Individual provider · Type 1 NPI
Katelyn Jeanne Wilson, PMHNP
Military Health Care Provider · Albuquerque, NM
NPI number
1619430907
Active
Practice location
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Mailing address
1030 Highlands Plaza Dr E Apt 202
St. Louis, MO 63110-1344
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Health Care Provider Primary | 171000000X | None listed |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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About NPI 1619430907
Katelyn Jeanne Wilson, PMHNP's National Provider Identifier is 1619430907, issued on Apr 12, 2019. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Albuquerque, NM. The record was last updated on Apr 12, 2019.