Individual
LAVENA S WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
222 ADLEY WAY, GREENVILLE, SC 29607
(864) 230-1665
(844) 596-0411
Mailing address
P.O. BOX 3834, GREENVILLE, SC 29608
(864) 230-1665
(844) 596-0411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4075
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN4075
SC
Other
Enumeration date
02/04/2010
Last updated
07/21/2022
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