Provider Demographics
NPI:1508136599
Name:WILKINSON, LINH MY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LINH
Middle Name:MY
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CAMINO SAN LUCAS
Mailing Address - Street 2:
Mailing Address - City:LAMY
Mailing Address - State:NM
Mailing Address - Zip Code:87540
Mailing Address - Country:US
Mailing Address - Phone:505-466-1698
Mailing Address - Fax:
Practice Address - Street 1:455 ST MICHAEL'S DRIVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-913-5707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP000074071835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist