| Katelyn Michelle Wilson, NP | |
|
3533 Southern Blvd Ste 5650, Kettering, OH 45429-1263 | |
| (937) 294-3611 | |
| Not Available |
| Full Name | Katelyn Michelle Wilson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Gerontology |
| Location | 3533 Southern Blvd Ste 5650, Kettering, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588484927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LG0600X | Nurse Practitioner - Gerontology | 0037888 (Ohio) | Primary |
| 163W00000X | Registered Nurse | 459403 (Ohio) | Secondary |
| Entity Name | Stafford Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679542021 PECOS PAC ID: 4486678901 Enrollment ID: O20060123000759 |
| Mailing Address | Practice Location Address |
|---|---|
| Katelyn Michelle Wilson, NP 70 Remick Blvd, Springboro, OH 45066-9168 Ph: (937) 885-0701 | Katelyn Michelle Wilson, NP 3533 Southern Blvd Ste 5650, Kettering, OH 45429-1263 Ph: (937) 294-3611 |
Holli N Kroger, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5450 Far Hills Ave, Kettering, OH 45429 Phone: 937-436-2866 Fax: 937-436-1468 | |
Ms. Noriko Tsuchihashi Banerjee, RN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 500 Lincoln Park Blvd, Suite 100, Kettering, OH 45429 Phone: 937-222-3118 Fax: 937-222-1436 | |
Erica Lee Ertel, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3700 Southern Blvd Ste 201, Kettering, OH 45429 Phone: 855-500-2873 Fax: 937-281-3992 | |
Lashauna Hall, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3700 Southern Blvd Ste 300, Kettering, OH 45429 Phone: 937-643-9299 Fax: 937-643-2343 | |
Mrs. Erika Vanwyck Thomas, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2115 E Dorothy Ln, Kettering, OH 45420 Phone: 937-610-9174 | |
Ms. Danyell Margioras, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3700 Southern Blvd Ste 300, Kettering, OH 45429 Phone: 937-643-9299 | |
Stephanie Lynn Henry, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3535 Southern Blvd, Kettering, OH 45429 Phone: 937-395-8166 |