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NPI Code Detail

MEDICARE: JENNIFER WILKINSON APRN

MEDICARE: JENNIFER WILKINSON APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner209024600IL
2363LP0808XPsychiatric/Mental Health Nurse Practitioner209024600IL

General Provider Information

NPI Number : 1710647870
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER WILKINSON APRN
Provider Business Mailing Address
First Line : 306 46TH AVE
Second Line :
City : EAST MOLINE
State : IL
Zip : 61244-4281
Country : US
Telephone Number : 309-796-2329
Fax Number :
Provider Business Practice Location Address
First Line : 306 46TH AVE
Second Line :
City : EAST MOLINE
State : IL
Zip : 61244-4281
Country : US
Telephone Number : 309-796-2329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2021
Last Update Date : 04/04/2024

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