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

Brandye Nicole Wilson, PA

Individual provider Medical Physician Assistant · NPI 1215189618

Brandye Nicole Wilson, PA is a Physician Assistant in Southaven, Mississippi. Qualified in 2008, 18 years ago. Practices with Ortho Express Holding Company, LLC, a 14-clinician group and accepts Medicare assignment. Licensed in Arkansas and Mississippi.

Years since qualifying
18
Licensed in
AR, MS
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

125 Goodman Rd W Ste D
Southaven, MS 38671-9481
Phone: (662) 932-3560
Fax: (662) 534-2330
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA00448 (MS)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA362 (AR)

Record details

NPI number1215189618
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 16, 2008
Last updated in NPPESSeptember 28, 2020
Certification dateSeptember 28, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Ortho Express Holding Company, Llc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Southaven