Individual
MS. SHANNA L. WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
17 CENTRE PLAZA DRIVE, JACKSON, TN 38305
(731) 512-0104
(731) 668-7388
Mailing address
17 CENTRE PLAZA DR, JACKSON, TN 38305-2862
(731) 512-0104
(731) 668-7388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12114
TN
363LA2200X
Adult Health Nurse Practitioner
12114
TN
Other
Enumeration date
07/07/2006
Last updated
10/12/2023
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