Individual
RUTHANNE WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
256 HONEYSUCKLE RD, STE 2, DOTHAN, AL 36305-1168
(334) 792-6736
(334) 792-6737
Mailing address
301 ANDREWS AVENUE, FORT RUCKER, AL 36362-7363
(334) 255-7363
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
—
891012990
—
AL
Enumeration date
05/14/2007
Last updated
03/07/2018
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