Ryan - Wilson, Kellie Marie

Ryan - Wilson, Kellie Marie is an individual health care provider with primary practice located at 220 E. Harris , San Angelo TX 76903. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Ryan - Wilson, Kellie Marie can be contacted via phone (325) 658-1511.

Contact Information

Primary practice address
220 E. Harris San Angelo TX 76903
Phone: (325) 658-1511
Fax: (325) 481-2165
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X AP111628 Texas
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X AP111628 Texas

Profile Details

NPI number 1255393872
LBN Legal business name Ryan - Wilson, Kellie Marie
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Dec 18th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255393872 NPPES
Texas MEDICAID 170388603
Texas Other 8Y3124

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