# KIMBERLY M. WILKINSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1316187057
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 085003302 | IL | — |
| 363A00000X | Physician Assistant | 10002145A | IN | Yes |

## Other

- **Enumeration date:** 02/20/2009
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 920540 | MEDICARE PTAN (GROUP) | IL |
| 01 | — | 920540022 | MEDICARE PTAN (INDIVIDUAL) | IL |
| 01 | — | DB1658 | RR MEDICARE PTAN (GROUP) | IL |
| 01 | — | P01104053 | RR MEDICARE PTAN (INDIVIDUAL) | IL |
| 01 | — | P01777161 | RR MEDICARE | IN |