Provider Demographics
NPI:1609623800
Name:WILKIE, NICOLE KAY FINLEY
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:KAY FINLEY
Last Name:WILKIE
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 1:60136 CINDER BUTTE RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-8959
Mailing Address - Country:US
Mailing Address - Phone:970-596-3513
Mailing Address - Fax:
Practice Address - Street 1:60136 CINDER BUTTE RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-8959
Practice Address - Country:US
Practice Address - Phone:970-596-3513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTHW000110740374J00000X
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula