Provider Demographics
NPI:1861025157
Name:WILKES, BESSIE A (CNA 1)
Entity Type:Individual
Prefix:
First Name:BESSIE
Middle Name:A
Last Name:WILKES
Suffix:
Gender:F
Credentials:CNA 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 BARRIER LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4730
Mailing Address - Country:US
Mailing Address - Phone:252-565-6674
Mailing Address - Fax:
Practice Address - Street 1:1410 BARRIER LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4730
Practice Address - Country:US
Practice Address - Phone:252-565-6674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-15
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC386554376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide