Provider Demographics
NPI:1578970141
Name:WILKES, TAMI (APRN)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:WILKES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:CEDAR KEY
Mailing Address - State:FL
Mailing Address - Zip Code:32625-0297
Mailing Address - Country:US
Mailing Address - Phone:352-325-0474
Mailing Address - Fax:833-776-0620
Practice Address - Street 1:510 2ND ST # 297
Practice Address - Street 2:
Practice Address - City:CEDAR KEY
Practice Address - State:FL
Practice Address - Zip Code:32625-5120
Practice Address - Country:US
Practice Address - Phone:352-325-0474
Practice Address - Fax:833-776-0620
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3234182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily