Provider Demographics
NPI:1457176075
Name:WILKINS, DEONDRA RASHAWN (RESIDENT IN COUNS)
Entity type:Individual
Prefix:
First Name:DEONDRA
Middle Name:RASHAWN
Last Name:WILKINS
Suffix:
Gender:F
Credentials:RESIDENT IN COUNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 LEESBURG PIKE APT 909
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3817
Mailing Address - Country:US
Mailing Address - Phone:571-332-3971
Mailing Address - Fax:
Practice Address - Street 1:12007 SUNRISE VALLEY DR STE 120
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3460
Practice Address - Country:US
Practice Address - Phone:571-977-6982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program