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NPI Code Detail

MEDICARE: AMANDA JEAN WILKENING MOTR/L

MEDICARE: AMANDA JEAN WILKENING MOTR/L
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
1225X00000XOccupational Therapist1451NE
2225X00000XOccupational Therapist103485MN
3225X00000XOccupational TherapistOTR2417AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730350802
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JEAN WILKENING MOTR/L
Provider Business Mailing Address
First Line : 150 SAINT ANDREWS CT
Second Line : SUITE 310
City : MANKATO
State : MN
Zip : 56001-8659
Country : US
Telephone Number : 507-388-5437
Fax Number : 507-388-2108
Provider Business Practice Location Address
First Line : 150 SAINT ANDREWS CT
Second Line : SUITE 310
City : MANKATO
State : MN
Zip : 56001-8659
Country : US
Telephone Number : 507-388-5437
Fax Number : 507-388-2108
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2008
Last Update Date : 05/08/2025

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1902236532 — LINDSAY PETERSON MS, OTR/L
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1124574439 — MELISSA HOKENESS I
Practice Location Address:
150 SAINT ANDREWS CT , SUITE 310
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