Provider Demographics
NPI:1518138734
Name:WILKERS, JULIET ANN (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:ANN
Last Name:WILKERS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 W BALTIMORE PIKE
Mailing Address - Street 2:OUTPATIENT PAVILLION SUITE 3303
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5104
Mailing Address - Country:US
Mailing Address - Phone:610-891-3490
Mailing Address - Fax:610-891-3493
Practice Address - Street 1:1068 W BALTIMORE PIKE
Practice Address - Street 2:OUTPATIENT PAVILLION SUITE 3303
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5104
Practice Address - Country:US
Practice Address - Phone:610-891-3490
Practice Address - Fax:610-891-3493
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-15
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003460133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered