Individual
ERICA TOY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
44 WATER STREET, OWINGSVILLE, KY 40360
(606) 674-9776
Mailing address
236 WEST MAIN ST., MT. STERLING, KY 40353
(859) 404-7686
(859) 498-8160
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2594
KY
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100636740
—
KY
Enumeration date
10/14/2019
Last updated
12/17/2019
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