Provider Demographics
NPI:1407613565
Name:WILKINS, ANEESAH AMIA CHRISTINE
Entity Type:Individual
Prefix:
First Name:ANEESAH
Middle Name:AMIA CHRISTINE
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 1:90 CHESSON FARM RD
Mailing Address - Street 2:
Mailing Address - City:ROPER
Mailing Address - State:NC
Mailing Address - Zip Code:27970-9385
Mailing Address - Country:US
Mailing Address - Phone:252-623-7352
Mailing Address - Fax:
Practice Address - Street 1:90 CHESSON FARM RD
Practice Address - Street 2:
Practice Address - City:ROPER
Practice Address - State:NC
Practice Address - Zip Code:27970-9385
Practice Address - Country:US
Practice Address - Phone:252-623-7352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide