Provider Demographics
NPI:1497580484
Name:WILKIN, LANDREE
Entity type:Individual
Prefix:
First Name:LANDREE
Middle Name:
Last Name:WILKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17859-8915
Mailing Address - Country:US
Mailing Address - Phone:570-683-6541
Mailing Address - Fax:
Practice Address - Street 1:289 HARRISON RD
Practice Address - Street 2:
Practice Address - City:ORANGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17859-8915
Practice Address - Country:US
Practice Address - Phone:570-683-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program