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Individual

MRS. LAURA DIANNE WILKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN- CRNA

Contact information

Practice address
18797 ALBERTA STREET, ONEIDA, TN 37841-2127
(865) 777-0909
(865) 777-0910
Mailing address
12752 KINGSTON PIKE, STE E202, KNOXVILLE, TN 37934-0948
(865) 777-0909
(865) 777-0910

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11198
TN
367500000X
Certified Registered Nurse Anesthetist
4723A
KY
367500000X
Certified Registered Nurse Anesthetist
87629
TN
367500000X
Certified Registered Nurse Anesthetist
RN1108135 ARNP4723A
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000001218303
CHA HEALTH
KY
01
000000382181
ANTHEM BCBS KY
KY
05
3630866
TN
01
4126702
BLUE CROSS/BLUE SHIELD
TN
05
74002270
KY
01
P00309974
RAILROAD MEDICARE PIN
KY
01
P00695348
RAILROAD MEDICARE PIN
TN
Enumeration date
05/11/2006
Last updated
01/11/2011
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