Individual
KAYCI DIAL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
815 S PINE ST, VIVIAN, LA 71082-3353
(318) 375-3239
(318) 375-2755
Mailing address
815 S PINE ST, VIVIAN, LA 71082-3353
(318) 375-3239
(318) 375-2755
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN097383
LA
363LF0000X
Family Nurse Practitioner
Primary
AP05072
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100360
—
LA
Enumeration date
04/20/2007
Last updated
10/16/2025
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