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Contact Information

KATHERINE A WILSON, PA-C
30 ARDISIA LANE
SAINT JOHNS, FL32259
 Phone: 904-287-2794
 Fax: 904-390-7458
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KATHERINE A WILSON · (Female)

NPI # 1235353988
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 04/12/2007
Last updated 09/20/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PA9104552
  • GA License # 005035
  • GA Medicaid 411072211A
Hospital affiliation(s)
  • BAPTIST MEDICAL CENTER - (Acute Care)
    800 PRUDENTIAL DR
    JACKSONVILLE, FL 32207
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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