Provider Demographics
NPI:1770399107
Name:WILKERSON, ARZERIA L
Entity type:Individual
Prefix:
First Name:ARZERIA
Middle Name:L
Last Name:WILKERSON
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 1:6003 FINANCIAL PLZ STE T
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2670
Mailing Address - Country:US
Mailing Address - Phone:318-606-5903
Mailing Address - Fax:318-635-3298
Practice Address - Street 1:6003 FINANCIAL PLZ STE T
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2670
Practice Address - Country:US
Practice Address - Phone:318-606-5903
Practice Address - Fax:318-635-3298
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)