P Praxis·MD
● Active Type 1 · Individual

MRS. Laura Renae Wilson, MSN, APRN-BC

Nurse Practitioner·Stone Mountain, GA· NPI 1104032218 · Enumerated 2007 · 19 years on NPI
Wilson is 1 of 3 nurse practitioner providers in Stone Mountain and 1 of 383 in Georgia.
NPI age
19 years
Enumerated 2007-05-15
Primary specialty
Nurse Practitioner
Plus 2 subspecialties
Licensed in
GA, CT, TX
3 states
Status
Active
No deactivations on record
Last NPPES update
2019-03-06
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 383 active nurse practitioner providers in Georgia.

NPI age
19 years
↑ 14 yr above median (5 yr)
State licenses
3 states
Top 93% — 6% of peers are multi-state
Subspecialties
1
In the 31% of peers with subspecialties

NPI lifetime · 2007 → 2026

2007-05Enumerated in NPPES
2007 2026

Where they practice

Practice location
5405 Memorial Dr Ste D
Stone Mountain, GA 300833236
📞 4042963800fax 4042978753
Mailing address
5405 Memorial Dr Ste D
Stone Mountain, GA 300833236
📞 4042963800fax 4042978753

Specialties

  • Nurse Practitioner Primary
    Definition to come...
    GA license #RN247115 taxonomy 363LP2300X
  • Nurse Practitioner
    Definition to come...
    CT license #004365TX license #701633 taxonomy 363LF0000X

Identifiers

TypeValueNotes
01 (TX) 1821185299 NPI - BVCAA
01 (TX) 1275620551 NPI - ROBERTSON COUNTY CHC
05 (TX) 154467803
01 (TX) 1649265646 NPI- BRYAN- COLLEGE STATION CHC
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.

Practice context

Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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