Provider Demographics
NPI:1447858592
Name:WILKES, SHARON D (CNA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:WILKES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-4629
Mailing Address - Country:US
Mailing Address - Phone:601-573-7993
Mailing Address - Fax:
Practice Address - Street 1:304 E ACADEMY ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-4629
Practice Address - Country:US
Practice Address - Phone:601-573-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty