Provider Demographics
NPI:1194582049
Name:WILKEY, HANNAH LOGAN
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LOGAN
Last Name:WILKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 STAUNTON DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1262
Mailing Address - Country:US
Mailing Address - Phone:217-416-8393
Mailing Address - Fax:
Practice Address - Street 1:2157 STAUNTON DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1262
Practice Address - Country:US
Practice Address - Phone:217-416-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program