Provider Demographics
NPI:1265112114
Name:WILSON, GALAXI ELISA (FNP-BC)
Entity type:Individual
Prefix:
First Name:GALAXI
Middle Name:ELISA
Last Name:WILSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:888-339-6065
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:10616 METROMONT PKWY STE 210
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7670
Practice Address - Country:US
Practice Address - Phone:704-774-6569
Practice Address - Fax:855-308-2340
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5018571363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner