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Individual

MARIA LYNN WILKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
211 E STADIUM, MAGNOLIA, AR 71753
(870) 234-5995
(870) 234-0278
Mailing address
211 E STADIUM, MAGNOLIA, AR 71753
(870) 234-5995
(870) 234-0278

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
A01690
AR
363LF0000X
Family Nurse Practitioner
Primary
A001690
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150702758
AR
01
A01690
STATE LICENSURE
AR
Enumeration date
06/12/2006
Last updated
06/10/2014
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