Provider Demographics
NPI:1124574066
Name:WILKINS, MARY ELIZABETH (APRN-BC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:WILKINS
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W CARL HUBBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:MEEKER
Mailing Address - State:OK
Mailing Address - Zip Code:74855
Mailing Address - Country:US
Mailing Address - Phone:405-279-4281
Mailing Address - Fax:405-279-4285
Practice Address - Street 1:102 W CARL HUBBELL BLVD
Practice Address - Street 2:
Practice Address - City:MEEKER
Practice Address - State:OK
Practice Address - Zip Code:74855
Practice Address - Country:US
Practice Address - Phone:405-279-4281
Practice Address - Fax:405-279-4285
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK89711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily