Most Relevant Information
Provider Data
| NPI Number: | 1003258567 |
| Provider Name: | DEBRA WILKERSON LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 043.114994 |
Most Important Dates
| Enumeration Date: | 07/25/2013 |
| Last Updated: | 07/25/2013 |
Provider Practice Location
988 N ILLINOIS ROUTE 3
WATERLOO
IL
622981000
Practice Location Phone/Fax
| Phone: | 6189394444 |
| Fax: | 6189394181 |
Provider Mailing Location
176 EDWARD ST
MARISSA
IL
622573552
Provider Mailing Phone/Fax
| Phone: | 6189755295 |
| Fax: | 6189394181 |