| Ms Kristin Nicole Wilson, NP-C | |
|
2011 4th St, La Grande, OR 97850-2511 | |
| (541) 963-4139 | |
| (541) 429-6612 |
| Full Name | Ms Kristin Nicole Wilson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 2011 4th St, La Grande, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851747596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | CNP-02899 (New Mexico) | Secondary |
| 363L00000X | Nurse Practitioner | 202000961NP-PP (Oregon) | Primary |
| Entity Name | Lisa Somoza Robles Md Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770754863 PECOS PAC ID: 8123000908 Enrollment ID: O20040604000416 |
| Entity Name | Santa Fe Mountain Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861695769 PECOS PAC ID: 6406272608 Enrollment ID: O20200819000307 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Kristin Nicole Wilson, NP-C 2011 4th St, La Grande, OR 97850-2511 Ph: (541) 963-4139 | Ms Kristin Nicole Wilson, NP-C 2011 4th St, La Grande, OR 97850-2511 Ph: (541) 963-4139 |
Jennifer Marie Province, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 University Blvd, La Grande, OR 97850 Phone: 541-962-3803 | |
Dr. Pamela M Mcwhirter, DNP, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 700 Sunset Dr, La Grande, OR 97850 Phone: 541-663-3030 Fax: 541-975-5201 | |
Linda Maureen Chernoff, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1807 Cove Ave, La Grande, OR 97850 Phone: 541-663-9008 | |
Dr. Gary Robert Laustsen, FNP, PHD Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 University Blvd, La Grande, OR 97850 Phone: 541-962-3132 | |
Heather Wiggins, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1 University Blvd, La Grande, OR 97850 Phone: 541-962-3825 | |
Scott Alden Widener, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 900 Sunset Dr, La Grande, OR 97850 Phone: 541-963-1412 Fax: 541-963-1488 | |
Jacqui Kleeman, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Depot St, La Grande, OR 97850 Phone: 541-963-3772 |