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

Jacquelyne Wilson, CRNP

Individual provider Nurse Practitioner · NPI 1447962220

Jacquelyne Wilson, CRNP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2022, 4 years ago. Practices with Stc Pediatrics LLC, a 70-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
4
Licensed in
PA
In the registry since
2022
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

160 E Erie Ave
Philadelphia, PA 19134-1011
Phone: (215) 427-5348
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP026860 (PA)

Record details

NPI number1447962220
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedDecember 23, 2022
Last updated in NPPESMarch 21, 2023
Certification dateMarch 21, 2023
Mailing addressPo Box 13579, Reading, PA 19612-3579

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Stc Pediatrics Llc — 70 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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