Healthcare Provider Details

I. General information

NPI: 1902225220
Provider Name (Legal Business Name): HANNAH B WILKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH R BAER

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS WAY # 512-1
LITTLE ROCK AR
72202-3500
US

IV. Provider business mailing address

1 CHILDRENS WAY # 653
LITTLE ROCK AR
72202-3500
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-1050
  • Fax: 501-364-6931
Mailing address:
  • Phone: 501-364-1100
  • Fax: 501-364-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-10492
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberE-10492
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: