Provider Demographics
NPI:1407248388
Name:WILKER, BARBARA LOUISE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LOUISE
Last Name:WILKER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2465 RESEARCH PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1089
Mailing Address - Country:US
Mailing Address - Phone:719-528-6450
Mailing Address - Fax:
Practice Address - Street 1:2465 RESEARCH PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1089
Practice Address - Country:US
Practice Address - Phone:719-528-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO904910124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO904910Medicaid