Provider Demographics
NPI:1811483324
Name:WILSON, ERIC J (ARNP)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:WILSON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2405 SE 17TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-9190
Mailing Address - Country:US
Mailing Address - Phone:352-690-2171
Mailing Address - Fax:352-690-6954
Practice Address - Street 1:6400 W NEWBERRY RD STE 210
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6602
Practice Address - Country:US
Practice Address - Phone:352-331-3583
Practice Address - Fax:352-331-3669
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9317347163W00000X
FLARNP9317347363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse