Provider Demographics
NPI:1346606522
Name:WILKINSON, KATHERINE OLSEN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:OLSEN
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 E 1090 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-3207
Mailing Address - Country:US
Mailing Address - Phone:801-369-9951
Mailing Address - Fax:
Practice Address - Street 1:247 E 1090 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3207
Practice Address - Country:US
Practice Address - Phone:801-369-9951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT309142-3101164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse