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General NPI Number Information
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NPI Number | 1477839728
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Entity Type | Individual
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Provider Name | NICOLE ANNE WILKINS EDD, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 800 S TUCKER DR
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City | TULSA
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State | OK
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Zip | 74104-9700
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Country | US
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Telephone | 918-631-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 S CONGRESS AVE
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City | AUSTIN
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State | TX
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Zip | 78704-6425
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Country | US
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Telephone | 512-416-5802
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Fax | 866-456-6076
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT4358
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT1148
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License Number State | OK
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