Individual
VIRGINIA F WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-5000
Mailing address
PO BOX 810, HANOVER, NH 03755-0810
(603) 308-1453
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2053
NH
363AM0700X
Medical Physician Assistant
796
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0746PA
—
SC
Enumeration date
12/05/2006
Last updated
02/07/2025
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