CHRISTOPHER WILSON MPH, MSN, AGACNP-BC, NPI 1275086084 — WESTMINSTER (MD)

NPI 1275086084

3+ Years Experience Individual

CHRISTOPHER WILSON MPH, MSN, AGACNP-BC

07/28/2016
PROVIDER ENUMERATION DATE
05.04.2019
LAST UPDATE DATE
1275086084
NPI NUMBER

About CHRISTOPHER WILSON

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

CHRISTOPHER WILSON is a provider established in WESTMINSTER, MD. The NPI number of CHRISTOPHER WILSON is 1275086084 and was assigned on 07/28/2016. The practitioners primary taxonomy code is: 363LA2100X with license number: APRN002295 NV .

Mailing address

  • City: FREDERICK
  • State: MD
  • Postal code: 217015631
  • Phone: 9173181079
  • Address: 201 E PATRICK ST # 819

Primary Practice Address

  • Region : WESTMINSTER, MD
  • NPI : 1275086084
  • Phone : 4108483000
  • Postalcode : 211575726
  • Address : 200 MEMORIAL AVE

Provider taxonomy - Nurse Practitioner

  • Taxonomy code: 363LA2100X
  • License number: APRN002295
  • License state: NV

The taxonomy is not the primary taxonomy.

Healthcare provider taxonomy #2 - Nurse Practitioner

  • Taxonomy code: 363LA2100X
  • License number: RN227882
  • License state: MD

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • CHRISTOPHER WILSON MPH, MSN, AGACNP-BC
  • Address : 200 MEMORIAL AVE
  • Region : WESTMINSTER, MD
  • NPI : 1275086084
  • Phone : 4108483000
  • Postalcode : 211575726

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address200 MEMORIAL AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameWESTMINSTER
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code211575726
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number4108483000
The telephone number associated with the location address of the provider being identified.
NPI1275086084
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1363LA2100X
Provider Enumeration Date07/28/2016
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated05.04.2019
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)CHRISTOPHER WILSON
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address201 E PATRICK ST # 819
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameFREDERICK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code217015631
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number9173181079
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1363LA2100X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Nurse Practitioner
Provider License Number 1APRN002295
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NV
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2363LA2100X
Healthcare Provider Taxonomy 2Nurse Practitioner
Provider License Number 2RN227882
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2MD
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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