Provider Demographics
NPI:1598205528
Name:WILSON, KATHARINE (RN, MSN, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:RN, MSN, WHNP-BC
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:
Other - Last Name:WHEELWRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1231 CANDELARIA RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107
Practice Address - Country:US
Practice Address - Phone:505-272-2158
Practice Address - Fax:505-272-8053
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-84082163W00000X
MARN2279657163W00000X
MDR217057163W00000X
NMCNP-03163363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse