Provider Demographics
NPI:1003412248
Name:WILKINSON, BRITNEY (CPNP)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1758
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-1758
Mailing Address - Country:US
Mailing Address - Phone:706-854-2500
Mailing Address - Fax:706-854-2559
Practice Address - Street 1:1120 15TH ST # OR-6000
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-5297
Practice Address - Country:US
Practice Address - Phone:706-726-9257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245347363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003256134AMedicaid