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

Kim Marie Wilson, CRNP

Individual provider Nurse Practitioner · NPI 1639383474

Kim Marie Wilson, CRNP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 1997, 29 years ago. Practices with University of Penn-Medical Group, a 3,401-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
29
Licensed in
PA
In the registry since
2007
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

3400 Spruce St 4 Dulles Bldg
Philadelphia, PA 19104-4206
Phone: (215) 615-4949
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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 TP004563U (PA)

Record details

NPI number1639383474
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedMay 10, 2007
Last updated in NPPESNovember 18, 2013

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice University Of Penn-Medical Group — 3401 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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