Provider Demographics
NPI:1235816554
Name:WILKINS, ANNIECIA MARLENA
Entity Type:Individual
Prefix:
First Name:ANNIECIA
Middle Name:MARLENA
Last Name:WILKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:FORT MITCHELL
Mailing Address - State:AL
Mailing Address - Zip Code:36856-4340
Mailing Address - Country:US
Mailing Address - Phone:334-538-4353
Mailing Address - Fax:
Practice Address - Street 1:22 BRADLEY DR
Practice Address - Street 2:
Practice Address - City:FORT MITCHELL
Practice Address - State:AL
Practice Address - Zip Code:36856-4340
Practice Address - Country:US
Practice Address - Phone:334-538-4353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health