MEDICARE: MS. MONICA GEZEIEL WILKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1396217329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA GEZEIEL WILKINS

Provider Business Mailing Address
First Line	:	3353 N JACKSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-3831
Country	:	US
Telephone Number	:	720-416-0055
Fax Number	:

Provider Business Practice Location Address
First Line	:	3353 N JACKSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-3831
Country	:	US
Telephone Number	:	720-416-0055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2019
Last Update Date	:	01/02/2019

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