National Provider Identifier
Lisa Marie Wilson, NP
Lisa Marie Wilson, NP is listed in the NPPES registry with a primary specialty of Registered Nurse in Rochester, NY and a listed phone number of (585) 397-3752.
Profile Overview
- NPI
- 1134415755
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- June 22, 2011
- Last Updated
- February 06, 2023
Practice Location
- 2760 Monroe Ave Ste 401B
- Rochester, NY 14618-4116
Phone: (585) 397-3752
Mailing Address
- PO Box 500
- Ellicottville, NY 14731-0500
Specialties
- Registered Nurse (163W00000X)
- Family Nurse Practitioner (363LF0000X)
Full Record
- NPI
- 1134415755
- Entity Type
- Individual
- Last Name
- Wilson
- First Name
- Lisa
- Middle Name
- Marie
- Credential
- NP
- Mailing Street Address
- PO Box 500
- Mailing City
- Ellicottville
- Mailing State
- NY
- Mailing ZIP Code
- 14731-0500
- Mailing Country
- US
- Mailing Phone
- (716) 699-9032
- Practice Street Address
- 2760 Monroe Ave Ste 401B
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14618-4116
- Practice Country
- US
- Practice Phone
- (585) 397-3752
- Enumeration Date
- June 22, 2011
- Last Updated
- February 06, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- February 06, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X), Family Nurse Practitioner (363LF0000X)
- Other Identifiers
- 1134415755 (NY)