Provider Demographics
NPI:1841836392
Name:WILKINS, KIZZY (APRN)
Entity type:Individual
Prefix:MS
First Name:KIZZY
Middle Name:
Last Name:WILKINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KIZZY
Other - Middle Name:
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:5447 DIVIDEND DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058
Mailing Address - Country:US
Mailing Address - Phone:770-322-8881
Mailing Address - Fax:770-322-8886
Practice Address - Street 1:5447 DIVIDEND DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058
Practice Address - Country:US
Practice Address - Phone:770-322-8881
Practice Address - Fax:770-322-8881
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPRN-NP253340363LF0000X
GARN253340163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty