Provider Demographics
NPI:1194863530
Name:WILKINSON, JANICE WALKUP (DPH)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:WALKUP
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 LONDONDERRY DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1386
Mailing Address - Country:US
Mailing Address - Phone:615-890-3647
Mailing Address - Fax:
Practice Address - Street 1:3026 OWEN DR
Practice Address - Street 2:SUITTE 116
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2417
Practice Address - Country:US
Practice Address - Phone:615-641-6845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist