Provider Demographics
NPI:1548027642
Name:WILKINSON, KIMBERLY A (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BURNHAM RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1854
Mailing Address - Country:US
Mailing Address - Phone:508-330-1842
Mailing Address - Fax:
Practice Address - Street 1:3 BURNHAM RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1854
Practice Address - Country:US
Practice Address - Phone:508-330-1842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH071649-21163WP0200X
MA270249163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics