Organization
RUTHANNE WILKES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTHANNE WILKES PMHNP (OWNER)
(334) 792-6736
Entity
Organization
Contact information
Practice address
256 HONEYSUCKLE ROAD, SUITE 2, DOTHAN, AL 36305-1168
(334) 792-6736
(334) 792-6737
Mailing address
256 HONEYSUCKLE RD STE 2, DOTHAN, AL 36305-1168
(334) 792-6736
(334) 792-6737
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-074982
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179654
—
AL
Enumeration date
04/11/2018
Last updated
04/11/2018
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