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

Jennifer Ann Brough Wilson, PA

Individual provider Physician Assistant · NPI 1053714089

Jennifer Ann Brough Wilson, PA is a Physician Assistant in Roseburg, Oregon. Qualified in 2014, 12 years ago. Practices with Weese Dermatology PC, a 5-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2014
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2440 NW Edenbower Blvd
Roseburg, OR 97471-8847
Phone: (541) 957-1141
Fax: (541) 957-1466
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 52022 (CA)

Record details

NPI number1053714089
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 5, 2014
Last updated in NPPESMarch 7, 2023
Certification dateJune 22, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Weese Dermatology Pc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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