Provider Demographics
NPI:1134300965
Name:WILKEN, JEFFREY ANDREW (AUD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ANDREW
Last Name:WILKEN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8321 SANGRE DE CRISTO RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6425
Mailing Address - Country:US
Mailing Address - Phone:303-984-4414
Mailing Address - Fax:303-984-6244
Practice Address - Street 1:8321 SANGRE DE CRISTO RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-6425
Practice Address - Country:US
Practice Address - Phone:303-984-4414
Practice Address - Fax:303-984-6244
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO205231H00000X
COAUD205231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO304934Medicare PIN
COAUD205OtherAUDIOLOGY LIC