Provider Demographics
NPI:1528307782
Name:WILKINSON, NATASHA RENEE (RN)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:RENEE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 RUNDELL DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1420
Mailing Address - Country:US
Mailing Address - Phone:937-838-2150
Mailing Address - Fax:
Practice Address - Street 1:4221 RUNDELL DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1420
Practice Address - Country:US
Practice Address - Phone:937-838-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN350418163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse