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NPI Code Detail

MEDICARE: KATIE L WILKERSON ARNP

MEDICARE:   KATIE L WILKERSON  ARNP
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
1363L00000XNurse PractitionerARNP 3073572FL

Other Identifiers

General Provider Information

NPI Number : 1891855532
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE L WILKERSON ARNP
Provider Business Mailing Address
First Line : PO BOX 534595
Second Line :
City : ATLANTA
State : GA
Zip : 30353-4595
Country : US
Telephone Number : 800-331-9294
Fax Number : 812-962-6425
Provider Business Practice Location Address
First Line : 20 SAN FILIPPO DR SE
Second Line :
City : PALM BAY
State : FL
Zip : 32909-2200
Country : US
Telephone Number : 321-725-8300
Fax Number : 321-725-1555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 04/20/2021

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Directions to “ KATIE L WILKERSON ARNP” Practice Location

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