Individual
CODY LANE WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
2921 SW 89TH ST, OKLAHOMA CITY, OK 73159-6332
(405) 757-7818
Mailing address
2921 SW 89TH ST, OKLAHOMA CITY, OK 73159-6332
(405) 757-7818
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
222567
OK
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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