MEDICARE: JAYLA WILKERSON

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	172A00000X	Driver		WI

General Provider Information

NPI Number	:	1841135324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYLA WILKERSON

Provider Business Mailing Address
First Line	:	2183 N HI MOUNT BLVD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-1112
Country	:	US
Telephone Number	:	414-223-2489
Fax Number	:

Provider Business Practice Location Address
First Line	:	2183 N HI MOUNT BLVD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-1112
Country	:	US
Telephone Number	:	414-223-2489
Fax Number	:

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

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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Directions to “ JAYLA WILKERSON ” Practice Location

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