Individual
KEIONNA WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
170 IVYWOOD LN, ROSWELL, GA 30076-1787
(323) 559-3205
Mailing address
PO BOX 896263, CHARLOTTE, NC 28289-6263
(323) 559-3205
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1180750
NC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/09/2023
Last updated
05/05/2026
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