Provider Demographics
NPI:1205168366
Name:WILSON, AIMEE KAY (RN)
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:KAY
Last Name:WILSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-1913
Mailing Address - Country:US
Mailing Address - Phone:724-859-2183
Mailing Address - Fax:
Practice Address - Street 1:815 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3301
Practice Address - Country:US
Practice Address - Phone:412-784-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-31
Last Update Date:2010-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN557271163WC0400X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical