Provider Demographics
NPI:1699022244
Name:WILKINS, JENNIFER L (MA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 EAST MOUNTAIN VIEW RD
Mailing Address - Street 2:244
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020
Mailing Address - Country:US
Mailing Address - Phone:602-361-5907
Mailing Address - Fax:
Practice Address - Street 1:1301 E MOUNTAIN VIEW RD
Practice Address - Street 2:244
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2269
Practice Address - Country:US
Practice Address - Phone:602-361-5907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider