Individual
JILL M WILKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4 DEERWOOD AVE, WADENA, MN 56482
(218) 631-1360
Mailing address
4 DEERWOOD AVE, WADENA MEDICAL CENTER, WADENA, MN 56482
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10825
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457665986
NPI
MN
Enumeration date
07/26/2010
Last updated
06/07/2011
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