Provider Demographics
NPI:1992952949
Name:WILKINS, GLADYS ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:ANN
Last Name:WILKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3510 OLD WASHINGTON RD
Mailing Address - Street 2:#100
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3233
Mailing Address - Country:US
Mailing Address - Phone:301-609-5209
Mailing Address - Fax:301-609-5220
Practice Address - Street 1:3510 OLD WASHINGTON RD
Practice Address - Street 2:#100
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3233
Practice Address - Country:US
Practice Address - Phone:301-609-5209
Practice Address - Fax:301-609-5220
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001408363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical