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MRS. LAURA RENAE WILSON MSN, APRN-BC
NPI 1104032218
Nurse Practitioner - Primary Care in Stone Mountain, GA

Active since May 15, 2007
5405 MEMORIAL DR STE D, STONE MOUNTAIN, GA 30083(404) 296-3800(404) 297-8753 Get Directions Write a Review

NPPES record last updated: March 6, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 6, 2019, Dec 11, 2015 (2 updates tracked since 2015).

About Mrs. Laura Renae Wilson Msn, Aprn-bc NPPES

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

MRS. LAURA RENAE WILSON MSN, APRN-BC (NPI 1104032218) is an individual primary care provider in Stone Mountain, Georgia, licensed in Georgia (RN247115) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1104032218
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameMRS. LAURA RENAE WILSONCredential: MSN, APRN-BC
Location Address5405 MEMORIAL DR STE DStone Mountain, GA 30083-3236
Mailing Address5405 Memorial Dr Ste DStone Mountain, GA 30083-3236 · (404) 296-3800 · Fax (404) 297-8753
Phone(404) 296-3800
Fax(404) 297-8753
Sole ProprietorYes
Enumeration DateMay 15, 2007
Last NPPES UpdateMarch 6, 20192 updates tracked since enumeration
✔ NPI 1104032218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in GA · RN247115
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 701633 (TX), 004365 (CT)
5405 MEMORIAL DR STE D, Stone Mountain, GA 30083
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Other Names 1

Former Name (1)Miss Laura Renae Phelps Msn, Aprn-bc

Other Identifiers 4

Other1649265646TX · Npi- Bryan- College Station Chc
Other1821185299TX · Npi - Bvcaa
Other1275620551TX · Npi - Robertson County Chc
Medicaid154467803TX

Other Providers at the Same Location NPPES 4

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

MR. JUSTIN STEWART KITCHENS NP-C
Nurse Practitioner (Family)
5405 MEMORIAL DR STE D
STONE MOUNTAIN, GA 30083
Dekalb County (404) 296-3800
LUCINDA JOHNSON SELLERS CPNP
Nurse Practitioner (Pediatrics)
5405 MEMORIAL DR STE D
STONE MOUNTAIN, GA 30083
Dekalb County (404) 296-3800
THE PEDIATRIC CENTER OF STONE MOUNTAIN
Pediatrics
5405 MEMORIAL DR STE D
STONE MOUNTAIN, GA 30083
Dekalb County (404) 296-3800
LAURA LYNN HUDSON-YEDVOBNICK PA
Physician Assistant
5405 MEMORIAL DR STE D
STONE MOUNTAIN, GA 30083
Dekalb County (404) 296-3800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Laura Wilson's NPI number?

The NPI number for Laura Wilson is 1104032218. It was assigned to this individual provider in the NPPES registry on May 15, 2007. The provider is also known as Miss Laura Renae Phelps Msn, Aprn-Bc.

Where is Laura Wilson located?

Laura Wilson practices at 5405 Memorial Dr Ste D, Stone Mountain, GA 30083. The listed phone number is (404) 296-3800.

What is Laura Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Laura Wilson was last updated on March 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.