# WILSON COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wilson Medical Center Professional
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992842942
- **Authorized official:** LORI C SMITH (CFO)
- **Authorized official phone:** (620) 325-8388

## Contact information

- **Practice address:** 2600 OTTAWA RD, NEODESHA, KS 66757-1897
- **Practice address phone:** (620) 325-2611
- **Practice address fax:** (620) 325-8459
- **Mailing address:** PO BOX 360, NEODESHA, KS 66757-0360
- **Mailing address phone:** (620) 325-2611
- **Mailing address fax:** (620) 325-8453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | H103002 | KS | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | H103002 | KS | — |

## Other

- **Enumeration date:** 01/31/2007
- **Last updated:** 09/25/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100099210D | — | KS |