RANDALL ANN WILSON AGACNP - NPI 1013420900 - Nurse Practitioner in Columbia, SC

Q: What is Randall Wilson's NPI number?

The NPI number for Randall Wilson is 1013420900. It was assigned to this individual provider in the NPPES registry on November 14, 2017.

Q: What is Randall Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Randall Wilson was last updated on November 14, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Randall Ann Wilson Agacnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDALL ANN WILSON AGACNP (NPI 1013420900) is an individual acute care provider in Columbia, South Carolina, licensed in South Carolina (21430) and active in the NPI registry since November 2017.

NPPES Registry Identity

NPI1013420900

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameRANDALL ANN WILSONCredential: AGACNP

Location Address6439 GARNERS FERRY RDColumbia, SC 29209-1638

Mailing Address6439 Garners Ferry RdColumbia, SC 29209-1638

Phone(803) 776-4000

Sole ProprietorNo

Enumeration DateNovember 14, 2017

✔ NPI 1013420900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in SC · 21430

6439 GARNERS FERRY RD, Columbia, SC 29209

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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