SHUNDRA WILSON FNP
NPI 1619346822
Nurse Practitioner - Family in Jackson, MS
About Shundra Wilson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHUNDRA WILSON FNP (NPI 1619346822) is an individual family provider in Jackson, Mississippi, licensed in Mississippi (R805409) and active in the NPI registry since September 2015.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
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.
JACKSON, MS 39213
JACKSON, MS 39213
JACKSON, MS 39213
JACKSON, MS 39213
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 Shundra Wilson's NPI number?
The NPI number for Shundra Wilson is 1619346822. It was assigned to this individual provider in the NPPES registry on September 17, 2015.
Where is Shundra Wilson located?
Shundra Wilson practices at 350 W Woodrow Wilson Ave, Jackson, MS 39213. The listed phone number is (601) 984-5615.
What is Shundra Wilson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
When was this NPI record last updated?
The NPPES record for Shundra Wilson was last updated on December 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Shundra Wilson, FNP · NPI 1619346822
Family physician in Jackson, Mississippi. Individual provider, active in the CMS NPPES registry since September 17, 2015.
## Identity
- **NPI:** 1619346822 (Entity type: Individual)
- **Enumerated:** September 17, 2015
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** R805409 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 350 W WOODROW WILSON AVE, Jackson, MS 39213-7681
- **Phone:** (601) 984-5615
## Record status
- **NPPES last updated:** December 28, 2015
- **Other identifiers:** Medicare PIN 451427YJ5D (MS); Medicaid 07900514 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1619346822) · Data from the CMS NPPES public registry.