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Contact Information

KELLIE M RYAN WILSON, CNM
220 E. HARRIS
SAN ANGELO, TX76903
 Phone: 325-658-1511
 Fax: 325-481-2165
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
 

Women's Health

363LW0102X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KELLIE M RYAN WILSON · (Female)

NPI Number 1255393872
Status Active
Credentials CNM (Certified Nurse Midwife)
Entity Individual
Enumeration date 04/06/2006
Last updated 12/18/2020 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • TX License # AP111628
  • TX Medicaid 170388603
  • TX Other 8Y3124 BCBS
Hospital affiliation(s)
  • SHANNON MEDICAL CENTER - (Acute Care)
    120 EAST HARRIS AVENUE
    SAN ANGELO, TX 76903
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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