Basic Information
| Provider Information | |||||||||
| NPI: | 1306434808 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILKERSON | ||||||||
| FirstName: | KAYLA | ||||||||
| MiddleName: | THERESE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, FNP-BC, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 COTTAGE WOODS CT | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277139361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5179454620 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 101 MANNING DR | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275144220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849746484 | ||||||||
| FaxNumber: | 9199667942 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2021 | ||||||||
| LastUpdateDate: | 01/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 5013955 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.