Provider Demographics
NPI:1144955238
Name:WILKINSON, KERRY ANN (CERTIFIED HAIR LOSS)
Entity type:Individual
Prefix:MRS
First Name:KERRY ANN
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:CERTIFIED HAIR LOSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-3020
Mailing Address - Country:US
Mailing Address - Phone:304-768-3655
Mailing Address - Fax:
Practice Address - Street 1:1228 OHIO AVE
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-3020
Practice Address - Country:US
Practice Address - Phone:304-767-4498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier