Provider Demographics
NPI:1639554090
Name:WILKS, DENISE (CNM)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:WILKS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 CONESTOGA RD
Mailing Address - Street 2:BLDG 1 STE 104
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1352
Mailing Address - Country:US
Mailing Address - Phone:610-525-6400
Mailing Address - Fax:610-525-4372
Practice Address - Street 1:919 CONESTOGA RD
Practice Address - Street 2:BLDG 1 STE 104
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-525-6400
Practice Address - Fax:610-525-4372
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010366176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife