Provider Demographics
NPI:1235996844
Name:WILKINS, DEANDRA EVETTE
Entity Type:Individual
Prefix:MRS
First Name:DEANDRA
Middle Name:EVETTE
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 1:11663 CONGRESSIONAL LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-9702
Mailing Address - Country:US
Mailing Address - Phone:317-270-0388
Mailing Address - Fax:
Practice Address - Street 1:2346 S LYNHURST DR STE 303
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-5171
Practice Address - Country:US
Practice Address - Phone:317-222-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator