Provider Demographics
NPI:1912593617
Name:ANNA KATHERINE WILKERSON MSN APN PA
Entity Type:Organization
Organization Name:ANNA KATHERINE WILKERSON MSN APN PA
Other - Org Name:HOMETOWN FAMILY HEALTH & WELLNESS, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/APN
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:501-521-1100
Mailing Address - Street 1:3345 HIGHWAY 5 N STE 300
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72019-9031
Mailing Address - Country:US
Mailing Address - Phone:501-521-1100
Mailing Address - Fax:501-621-1233
Practice Address - Street 1:3345 HIGHWAY 5 N STE 300
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72019-9031
Practice Address - Country:US
Practice Address - Phone:501-521-1100
Practice Address - Fax:501-621-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care