Provider Demographics
NPI:1427156215
Name:WILKINS, DELIA D (PA)
Entity type:Individual
Prefix:
First Name:DELIA
Middle Name:D
Last Name:WILKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4905
Mailing Address - Country:US
Mailing Address - Phone:850-769-1462
Mailing Address - Fax:850-769-9040
Practice Address - Street 1:229 SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4905
Practice Address - Country:US
Practice Address - Phone:850-769-1462
Practice Address - Fax:850-769-9040
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3143363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH92759Medicare UPIN
FLE2974YMedicare PIN
FLS88052Medicare UPIN