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General NPI Number Information
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NPI Number | 1922914399
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Entity Type | Individual
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Provider Name | AUDRA J. WILSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 626 ROUTE 10
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City | GILSUM
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State | NH
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Zip | 03448
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Country | US
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Telephone | 603-338-8757
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Fax |
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Provider Business Mailing Address
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Address Line | 135 SILENT WAY
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City | KEENE
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State | NH
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Zip | 03431-4739
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Country | US
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Telephone | 603-338-8757
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 067531-23
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License Number State | NH
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