Provider Demographics
NPI:1922574326
Name:WILKINS, EMILY G (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:G
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 TAUNTON BLVD STE A2
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-3471
Mailing Address - Country:US
Mailing Address - Phone:856-983-5551
Mailing Address - Fax:
Practice Address - Street 1:239 TAUNTON
Practice Address - Street 2:A-2
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055
Practice Address - Country:US
Practice Address - Phone:856-983-5551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ008584002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry