Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN245347 | GA |
NPI | 1003412248 |
---|---|
Provider Name | Britney Wilkinson |
First Address | Augusta, GA 30912-0004 |
Second Address | Grovetown, GA 30813-5297 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2020 |
Last Update Date | 24/09/2021 |