Provider Demographics
NPI:1770915795
Name:WILKEY, MARSHA ELLEN (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:ELLEN
Last Name:WILKEY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8990 LORRAINE RD
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4176
Mailing Address - Country:US
Mailing Address - Phone:228-833-1331
Mailing Address - Fax:228-224-1608
Practice Address - Street 1:7250 POE AVE STE 220
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2687
Practice Address - Country:US
Practice Address - Phone:937-912-3305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0036406363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health