Individual
ELLEN ROSSER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1915 K M WICKER MEMORIAL DR, CENTRAL CAROLINA ENT ASSOCIATES, SANFORD, NC 27330-5070
(919) 774-6829
(919) 775-2327
Mailing address
1915 K M WICKER MEMORIAL DR, CENTRAL CAROLINA ENT ASSOCIATES, SANFORD, NC 27330-5070
(919) 774-6829
(919) 775-2327
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2126
NC
237700000X
Hearing Instrument Specialist
588
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126
AUDIOLOGIST LICENSE #
—
01
—
3404108
MEDICAID HEARING AID VENDOR
NC
05
—
890107W
—
NC
Enumeration date
05/01/2008
Last updated
05/05/2026
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