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

Jacqueline Wilson, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1912681644

Jacqueline Wilson, AGACNP is an Acute Care Nurse Practitioner in Ronkonkoma, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2023

Practice location Address checks out

49 N Ocean Ave
Ronkonkoma, NY 11779-5015
Phone: (631) 487-8997
Show map & directions

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

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 432663 (NY)

Record details

NPI number1912681644
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorYes
NPI enumeratedJune 13, 2023
Last updated in NPPESJune 13, 2023
Certification dateJune 13, 2023