Provider Demographics
NPI:1831441302
Name:WILSON, KERI HUGGINS (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KERI
Middle Name:HUGGINS
Last Name:WILSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:HUGGINS
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:501 AIR PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-3000
Mailing Address - Country:US
Mailing Address - Phone:034-085-8349
Mailing Address - Fax:903-408-5693
Practice Address - Street 1:1080 E LENNON DR STE 3
Practice Address - Street 2:
Practice Address - City:EMORY
Practice Address - State:TX
Practice Address - Zip Code:75440-5253
Practice Address - Country:US
Practice Address - Phone:903-473-2060
Practice Address - Fax:903-473-2686
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX660444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily