Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 19671 | KY |
NPI | 1013917798 |
---|---|
Provider Name | Dr. Shirley A Wilkerson |
First Address | Louisville, KY 40202-1835 |
Second Address | Louisville, KY 40202-1835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 09/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64196710 | (05) | KY |
C68121 | (02) | KY |