Provider Demographics
NPI:1013283258
Name:WILKINS, ASHLEY ELIZABETH (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:WILKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:VAN HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11849 STATE ROUTE 34
Mailing Address - Street 2:
Mailing Address - City:CATO
Mailing Address - State:NY
Mailing Address - Zip Code:13033-3364
Mailing Address - Country:US
Mailing Address - Phone:315-406-8472
Mailing Address - Fax:
Practice Address - Street 1:11849 STATE ROUTE 34
Practice Address - Street 2:
Practice Address - City:CATO
Practice Address - State:NY
Practice Address - Zip Code:13033-3364
Practice Address - Country:US
Practice Address - Phone:315-406-8472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10308141164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse