# DR. NICOLE APRIL WILSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1336588326
- **Gender:** F
- **Credential:** PH.D., M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | 304415 | NY | — |
| 2086S0120X | Pediatric Surgery Physician | 45923 | OK | Yes |

## Other

- **Enumeration date:** 06/23/2013
- **Last updated:** 09/17/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 06055958 | — | NY |
| 01 | — | 2018008652 | STATE OF MISSOURI | MO |
| 01 | — | 304415 | STATE OF NEW YORK | NY |