Individual
MR. JAMIE WILSON IV
Active
Individual
MR. JAMIE WILSON IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11020316
FL
363LF0000X
Family Nurse Practitioner
APRN11020316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119817600
—
FL
01
—
JXSUE
BCBS
FL
Enumeration date
06/20/2022
Last updated
05/24/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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