Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP119444 | TX |
N | 363LA2100X | Nurse Practitioner - Acute Care | AP119444 | TX |
N | 363LC1500X | Nurse Practitioner - Community Health | AP119444 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 680616 | TX |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP119444 | TX |
N | 363LP2300X | Nurse Practitioner - Primary Care | AP119444 | TX |
NPI | 1396045506 |
---|---|
Provider Name | Dusty R Wilkins |
First Address | San Antonio, TX 78260-1453 |
Second Address | San Antonio, TX 78230-5141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2010 |
Last Update Date | 25/03/2019 |