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General NPI Number Information
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NPI Number | 1902431885
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Entity Type | Individual
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Provider Name | NICHOLE PARKER WILSON MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 01/03/2026
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Provider Practice Location Address
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Address Line | 226 VENTURE DR
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City | SMITHFIELD
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State | NC
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Zip | 27577-4721
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Country | US
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Telephone | 919-355-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 560G PARKERTOWN RD
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City | FOUR OAKS
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State | NC
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Zip | 27524-8907
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Country | US
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Telephone | 919-398-1482
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F01200458
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5013027
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License Number State | NC
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