Basic Information
| Provider Information | |||||||||
| NPI: | 1457483810 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILKINSON | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | CLARK | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN, CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 PILOT MEDICAL DRIVE | ||||||||
| Address2: | #300 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058562284 | ||||||||
| FaxNumber: | 2058154864 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 PILOT MEDICAL DRIVE | ||||||||
| Address2: | #300 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058562284 | ||||||||
| FaxNumber: | 2058154864 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2007 | ||||||||
| LastUpdateDate: | 01/14/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 1088072 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 51541873 | 01 | AL | BCBS | OTHER |