Individual
ANTOINETTE WILKES-WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
4604 HALLORAN CT, UPPER MARLBORO, MD 20772-6122
(301) 574-0979
Mailing address
75TH MC (AS), UNIT #15190, BOX 81, APO, AP 96271
(301) 574-0979
(315) 753-8112
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
177200
NC
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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