Provider Demographics
NPI:1457902009
Name:WILKERSON, JOAN ROMAINE (PERSONAL CAREGIVER)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ROMAINE
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:PERSONAL CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 WEST EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46 WEST EUCLID AVE
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063
Practice Address - Country:US
Practice Address - Phone:412-360-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider