Provider Demographics
NPI:1598265308
Name:WILKINS, DENISE DIANE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:DIANE
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 1:149 JAY KELLEY LANE
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:TX
Mailing Address - Zip Code:76270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:149 JAY KELLEY LANE
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:TX
Practice Address - Zip Code:76270
Practice Address - Country:US
Practice Address - Phone:903-975-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146116164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse