=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447870233
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER WILKINSON MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/21/2020
-----------------------------------------------------
Last Update Date | 09/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21108 CEDAR CT
-----------------------------------------------------
City | LAWRENCE TOWNSHIP
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08648-1263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-831-4846
-----------------------------------------------------
Fax | 609-710-0964
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21108 CEDAR CT
-----------------------------------------------------
City | LAWRENCE TOWNSHIP
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08648-1263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-831-4846
-----------------------------------------------------
Fax | 609-710-0964
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD488352
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 25MA12246600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------