Provider Demographics
NPI:1356972046
Name:WILKEY, RUTHIE ANNAMAY (MSN BSN RN)
Entity type:Individual
Prefix:
First Name:RUTHIE
Middle Name:ANNAMAY
Last Name:WILKEY
Suffix:
Gender:F
Credentials:MSN BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3664 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1402
Mailing Address - Country:US
Mailing Address - Phone:269-759-8215
Mailing Address - Fax:
Practice Address - Street 1:3664 CARDINAL DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1402
Practice Address - Country:US
Practice Address - Phone:269-759-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704234395163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse