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General NPI Number Information
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NPI Number | 1770098378
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Entity Type | Individual
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Provider Name | ELIZABETH GRACE WILKINSON MSN, FNP-BC, RNC-OB
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Gender | Female
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 3711 LONG BEACH BLVD., STE 700
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City | LONG BEACH
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State | CA
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Zip | 90807-3353
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Country | US
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Telephone | 562-634-8812
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Fax | 562-424-8770
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Provider Business Mailing Address
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Address Line | 3711 LONG BEACH BLVD., STE 700
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City | LONG BEACH
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State | CA
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Zip | 90807-3353
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Country | US
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Telephone | 562-634-8812
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Fax | 562-424-8770
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP95006946
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License Number State | CA
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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 | 95006946
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 95006946
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 95006946
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License Number State | CA
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