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

Lisa Nicole Wilson, NP

Individual provider Nurse Practitioner · NPI 1942182472

Lisa Nicole Wilson, NP is a Nurse Practitioner in Port Jefferson, New York. Licensed in New York. Registered with an NPI since 2025.

Licensed in
NY
In the registry since
2025
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

640 Belle Terre Rd
Port Jefferson, NY 11777-1936
Phone: (631) 828-5361
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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 F312374-01 (NY)

Record details

NPI number1942182472
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 24, 2025
Last updated in NPPESJuly 24, 2025
Certification dateJuly 24, 2025

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