Provider Demographics
NPI:1346606860
Name:WILKERSON, REGINA DAWN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:DAWN
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:PO BOX 636961
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6961
Mailing Address - Country:US
Mailing Address - Phone:888-696-3541
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:225 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 402
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-442-0103
Practice Address - Fax:270-442-0109
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2016-04-05
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Provider Licenses
StateLicense IDTaxonomies
KY3010183363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology