Provider Demographics
NPI:1679882708
Name:WILKES, ELLEN PARKER (ANP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:PARKER
Last Name:WILKES
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MS
Other - First Name:ELLEN
Other - Middle Name:STOCKTON
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:100 EASTOWNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:984-974-6599
Mailing Address - Fax:984-974-2680
Practice Address - Street 1:100 EASTOWNE DRIVE
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:984-974-6599
Practice Address - Fax:984-974-2680
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC209374363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner