Healthcare Provider Details

I. General information

NPI: 1902054638
Provider Name (Legal Business Name): ERICA ANN WONSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2008
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 KIMBERLEY CIR
BRUNSWICK ME
04011-3815
US

IV. Provider business mailing address

2 KIMBERLEY CIR
BRUNSWICK ME
04011-3815
US

V. Phone/Fax

Practice location:
  • Phone: 207-595-1954
  • Fax:
Mailing address:
  • Phone: 207-595-1954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number27716
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: