Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APN.0997018-NP | CO |
NPI | 1083377873 |
---|---|
Provider Name | Jessica Ann Wilkerson |
First Address | Littleton, CO 80122-2634 |
Second Address | Littleton, CO 80122-2634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2021 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9000198558 | (05) | CO |