Provider Demographics
NPI:1356095418
Name:WILSON, ARIEL RAIN (RPH)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:RAIN
Last Name:WILSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 MILLBROOK WOODS DR UNIT 303
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-2972
Mailing Address - Country:US
Mailing Address - Phone:443-949-5275
Mailing Address - Fax:
Practice Address - Street 1:1900 CAMERON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1307
Practice Address - Country:US
Practice Address - Phone:919-833-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist