Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brandon Wilson, CNP

Individual provider Family Nurse Practitioner · NPI 1689207292

Brandon Wilson, CNP is a Nurse Practitioner in Newark, Ohio. Qualified in 2019, 7 years ago. Practices with Licking Memorial Professional Corporation, a 235-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
7
Licensed in
OH
In the registry since
2020
Specialties on file
2
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

1320 W Main St
Newark, OH 43055-1822
Phone: (220) 564-4475
Fax: (220) 564-4412
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1069 Delaware Ave, Marion, OH 43302-1400 — (740) 223-3496

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 026226 (OH)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 026226 (OH)

Record details

NPI number1689207292
Entity typeIndividual (Type 1)
GenderMale
Credentials CNP
Sole proprietorNo
NPI enumeratedFebruary 21, 2020
Last updated in NPPESDecember 15, 2022
Certification dateDecember 15, 2022
Mailing address1320 W Main St, Newark, OH 43055-1822

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Licking Memorial Professional Corporation — 235 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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