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General NPI Number Information
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NPI Number | 1639549868
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Entity Type | Individual
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Provider Name | NAKESHA WILKES NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 700 BROOKSTONE CENTRE PKWY
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City | COLUMBUS
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State | GA
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Zip | 31904-9259
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Country | US
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Telephone | 706-653-0835
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 JACKSON ST
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City | OPELIKA
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State | AL
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Zip | 36804-7824
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Country | US
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Telephone | 706-590-5705
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-115079
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN214879
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License Number State | GA
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