Individual
KAREN WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
664 ORANGE COURT, ROCKLEDGE, FL 32955
(321) 208-0245
(321) 406-0926
Mailing address
664 ORANGE CT, ROCKLEDGE, FL 32955-2413
(321) 208-0245
(321) 506-0926
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
6906685
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6906685
ADULT FAMILY CARE HOME
FL
05
—
6906685
—
FL
Enumeration date
10/30/2014
Last updated
10/30/2014
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