Basic Information
| Provider Information | |||||||||
| NPI: | 1952857641 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILKINSON | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2060 N PEARL ST | ||||||||
| Address2: | |||||||||
| City: | NORTH EAST | ||||||||
| State: | PA | ||||||||
| PostalCode: | 164281926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148777711 | ||||||||
| FaxNumber: | 8148777715 | ||||||||
| Practice Location | |||||||||
| Address1: | 2060 N PEARL ST | ||||||||
| Address2: | |||||||||
| City: | NORTH EAST | ||||||||
| State: | PA | ||||||||
| PostalCode: | 164281926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148777711 | ||||||||
| FaxNumber: | 8148777715 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2016 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MA058574 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | OA003920 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.