Individual
MRS. CHANEL JANES WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP
Contact information
Practice address
201 POSEY AVE, CLIFTON, TX 76634-1200
(254) 675-8621
(254) 675-2254
Mailing address
PO BOX 72, CLIFTON, TX 76634-0072
(254) 675-8621
(254) 675-2254
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP112619
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP112619
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1624892-03
—
TX
05
—
162489204
—
TX
01
—
262918YLPS
WELLMED MEDICAL GROUP PA
TX
01
—
H08Y870101
BCBS
TX
01
—
P00673289
MEDICARE RR
—
Enumeration date
06/16/2005
Last updated
02/15/2024
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