Provider Demographics
NPI:1518618016
Name:WILKINS, JANNAI
Entity Type:Individual
Prefix:
First Name:JANNAI
Middle Name:
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 1:9480 PRINCETON SQUARE BLVD S APT 1002
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8311
Mailing Address - Country:US
Mailing Address - Phone:904-418-1401
Mailing Address - Fax:
Practice Address - Street 1:9480 PRINCETON SQUARE BLVD S APT 1002
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-8311
Practice Address - Country:US
Practice Address - Phone:904-418-1401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL238134372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion