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General NPI Number Information
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NPI Number | 1225682404
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Entity Type | Individual
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Provider Name | SHARDA RENEE WILKES LPN
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Gender | Female
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Dates
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Enumeration Date | 07/26/2019
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 401 MOYE BLVD
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City | GREENVILLE
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State | NC
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Zip | 27834-2885
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Country | US
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Telephone | 252-830-2149
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 TILGHMAN RD N
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City | WILSON
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State | NC
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Zip | 27893-1919
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Country | US
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Telephone | 252-640-0827
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 83698
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License Number State | NC
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