Individual
JENNIFER ELAINE WILMOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
160 KIMEL FOREST DR, SUITE 100, WINSTON SALEM, NC 27103-6074
(336) 714-6400
Mailing address
131 SAUNDERSVILLE RD STE 160, HENDERSONVILLE, TN 37075-8940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103852
NC
363AM0700X
Medical Physician Assistant
103852
NC
Other
Enumeration date
05/04/2006
Last updated
10/28/2020
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