Individual
VENICE LUCIA WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
412 N 200 E, LOGAN, UT 84321-4038
(435) 713-2710
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11159450-1206
UT
363A00000X
Physician Assistant
9110986
FL
363A00000X
Physician Assistant
PT904
WY
Other
Enumeration date
01/23/2018
Last updated
01/08/2026
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