Healthcare Provider Details

I. General information

NPI: 1124326178
Provider Name (Legal Business Name): ERIN N WILSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2011
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12748 BOLEN RD NE
NEWARK OH
43055-8842
US

IV. Provider business mailing address

12748 BOLEN RD NE
NEWARK OH
43055-8842
US

V. Phone/Fax

Practice location:
  • Phone: 614-949-1207
  • Fax:
Mailing address:
  • Phone: 614-949-1207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.366885
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: