LISA NICOLE WILSON NP
NPI 1942182472
Nurse Practitioner in Port Jefferson, NY

Q: What is Lisa Wilson's NPI number?

The NPI number for Lisa Wilson is 1942182472. It was assigned to this individual provider in the NPPES registry on July 24, 2025.

Q: What is Lisa Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Wilson was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since July 24, 2025

640 BELLE TERRE RD, PORT JEFFERSON, NY 11777(631) 828-5361 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lisa Nicole Wilson Np NPPES

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

LISA NICOLE WILSON NP (NPI 1942182472) is an individual nurse practitioner in Port Jefferson, New York, licensed in New York (F312374-01) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1942182472

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameLISA NICOLE WILSONCredential: NP

Location Address640 BELLE TERRE RDPort Jefferson, NY 11777-1936

Mailing Address195 N Utica AveNorth Massapequa, NY 11758-2143 · (347) 423-1784

Phone(631) 828-5361

Sole ProprietorNo

Enumeration DateJuly 24, 2025

NPPES CertifiedJuly 24, 2025

✔ NPI 1942182472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NY · F312374-01

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

640 BELLE TERRE RD, Port Jefferson, NY 11777

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Other Providers at the Same Location NPPES 15

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

CHRISTOPHER BEATTY, MD, PC

Surgery

640 BELLE TERRE RD
PORT JEFFERSON, NY 11777

Suffolk County (631) 928-7300

MRS. DARLENE RENEE PETROCCIONE RD, CDN

Dietitian, Registered

640 BELLE TERRE RD, BUILDING E
PORT JEFFERSON, NY 11777

Suffolk County (631) 987-4006

ROBERT M WOZNICKI MD PC

Psychiatry & Neurology (Psychiatry)

640 BELLE TERRE RD, BLDG J3
PORT JEFFERSON, NY 11777

Suffolk County (631) 928-3184

MS. REGINA M TART LMT

Massage Therapist

640 BELLE TERRE RD
PORT JEFFERSON, NY 11777

Suffolk County (631) 828-5361

FIROOZ REZVANI MD

Otolaryngology

640 BELLE TERRE RD, BLDG J
PORT JEFFERSON, NY 11777

Suffolk County (631) 928-2121

PORT NEUROLOGY PC

Specialist

640 BELLE TERRE RD, BUILDING H
PORT JEFFERSON, NY 11777

Suffolk County (631) 331-8774

GISOU SAFFARI LMT

Massage Therapist

640 BELLE TERRE RD, BLDG E
PORT JEFFERSON, NY 11777

Suffolk County (631) 921-5326

HENRY J BEST IV D.O.

Family Medicine

640 BELLE TERRE RD, BLDG F
PORT JEFFERSON, NY 11777

Suffolk County (631) 928-6900

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 Lisa Wilson's NPI number?

The NPI number for Lisa Wilson is 1942182472. It was assigned to this individual provider in the NPPES registry on July 24, 2025.

Where is Lisa Wilson located?

Lisa Wilson practices at 640 Belle Terre Rd, Port Jefferson, NY 11777. The listed phone number is (631) 828-5361.

What is Lisa Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Lisa Wilson was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.