Provider Demographics
NPI:1053723056
Name:WILSON, ERIKA FREESE (MD/MPH)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:FREESE
Last Name:WILSON
Suffix:
Gender:F
Credentials:MD/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRONT ST UNIT 100
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2727
Mailing Address - Country:US
Mailing Address - Phone:603-778-2005
Mailing Address - Fax:
Practice Address - Street 1:24 FRONT ST UNIT 100
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2727
Practice Address - Country:US
Practice Address - Phone:603-778-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-24
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH220242084P0800X
NC2018-017162084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program