Provider Demographics
NPI:1184336356
Name:WILKINSON, TRACI (FNP-C)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9057 E MISSISSIPPI AVE APT 4-201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2080
Mailing Address - Country:US
Mailing Address - Phone:319-470-8070
Mailing Address - Fax:
Practice Address - Street 1:6850 E EVANS AVE SUITE 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2300
Practice Address - Country:US
Practice Address - Phone:303-691-5009
Practice Address - Fax:303-691-8897
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN0998293-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily