Jaquell Wilson, is a
Non-emergency Medical Transport (van) based in Petersburg, Virginia. Jaquell Wilson is licensed to practice in * (Not Available) (license number ) and her current practice location is
43 Rives Rd Ste 1c, Petersburg, Virginia. She can be reached at her office (for appointments etc.) via phone at
(804) 805-8775.
NPI number for Jaquell Wilson is 1558000117 and her current mailing address is 4807 Tooley Dr, Chester, Virginia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1558000117.
Provider's Profile
| Full Name | Jaquell Wilson |
|---|
| Gender | Female |
|---|
| Speciality | Non-emergency Medical Transport (van) |
|---|
| Location | 43 Rives Rd Ste 1c, Petersburg, Virginia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1558000117
- Provider Enumeration Date: 06/01/2022
- Last Update Date: 06/01/2022
Medical Identifiers
Medical identifiers for Jaquell Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558000117 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 0001301085 (Virginia) | Secondary |
| 342000000X | Transportation Network Company | (* (Not Available)) | Secondary |
| 343800000X | Secured Medical Transport (van) | (* (Not Available)) | Secondary |
| 343900000X | Non-emergency Medical Transport (van) | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jaquell Wilson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jaquell Wilson,
4807 Tooley Dr,
Chester, VA 23831-6631
Ph: (434) 480-6111 | Jaquell Wilson,
43 Rives Rd Ste 1c,
Petersburg, VA 23805-9255
Ph: (804) 805-8775 |
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