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

Kenyatta Nicole Wilson, NP-C

Individual provider Family Nurse Practitioner · NPI 1457633034

Kenyatta Nicole Wilson, NP-C is a Nurse Practitioner in Vicksburg, Mississippi. Qualified in 2011, 15 years ago. Practices with Medical Foundation of Central Mississippi Inc, a 273-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
15
Licensed in
MS
In the registry since
2011
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

2200 Highway 61 N
Vicksburg, MS 39183-8246
Phone: (601) 883-3340
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 106 Clinton Pkwy, Clinton, MS 39056-4730 — (601) 924-9005

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R871546 (MS)

Record details

NPI number1457633034
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedSeptember 9, 2011
Last updated in NPPESMay 29, 2023
Certification dateMay 29, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Medical Foundation Of Central Mississippi Inc — 273 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Vicksburg