Provider Demographics
NPI:1457483810
Name:WILKINSON, RACHEL CLARK (RN, CRNP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:CLARK
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PILOT MEDICAL DRIVE
Mailing Address - Street 2:#300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235
Mailing Address - Country:US
Mailing Address - Phone:205-856-2284
Mailing Address - Fax:205-815-4864
Practice Address - Street 1:100 PILOT MEDICAL DRIVE
Practice Address - Street 2:#300
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235
Practice Address - Country:US
Practice Address - Phone:205-856-2284
Practice Address - Fax:205-815-4864
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1088072363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51541873OtherBCBS
AL510I500339Medicare PIN