Provider Demographics
NPI:1912271669
Name:WILSON, ALECIA (CRNA)
Entity Type:Individual
Prefix:
First Name:ALECIA
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALECIA
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:DEPT # 1499
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-1499
Mailing Address - Country:US
Mailing Address - Phone:251-690-1238
Mailing Address - Fax:
Practice Address - Street 1:1 MOBILE INFIRMARY CIR
Practice Address - Street 2:FLOOR 2
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3522
Practice Address - Country:US
Practice Address - Phone:251-435-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-104475367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered