Abby Jan Wilson, RD, LD, CDE is a
Nurse Practitioner - Family based in Pocatello, Idaho. Abby Jan Wilson is licensed to practice in Idaho (license number 3771381) and her current practice location is
957 Hospital Way Bldg D, Pocatello, Idaho. She can be reached at her office (for appointments etc.) via phone at
(208) 239-2070.
NPI number for Abby Jan Wilson is 1033544580 and her current mailing address is 957 Hospital Way Bldg D, Pocatello, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1033544580.
Healthcare Provider's Profile
| Full Name | Abby Jan Wilson |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Family |
|---|
| Location | 957 Hospital Way Bldg D, Pocatello, Idaho |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1033544580
- Provider Enumeration Date: 09/03/2013
- Last Update Date: 02/20/2026
Medical Identifiers
Medical identifiers for Abby Jan Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1033544580 | NPI | - | NPPES |
| 1790751055 | Other | ID | HOSPITAL NPI# |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 133V00000X | Dietitian, Registered | D-795 (Idaho) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 3771381 (Idaho) | 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. Abby Jan 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 |
Abby Jan Wilson, RD, LD, CDE 957 Hospital Way Bldg D, Pocatello, ID 83201-5096 Ph: (208) 239-2070 | Abby Jan Wilson, RD, LD, CDE 957 Hospital Way Bldg D, Pocatello, ID 83201-5096 Ph: (208) 239-2070 |
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