| Doctor Name: | PENELOPE WILKE |
| NPI Number: | 1093833642 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 20407 |
| Business Practice Address: | 5647 U.s. Highway 26 Dubois, WY - 82513 |
| Business Phone Number: | 3074552516 |
| Business Fax Number: | 3074552526 |
| Mailing Address: | Po Box 577, DUBOIS |
| State: | WY |
| Postal Code: | 825130577 |
| Phone Number: | 3074552516 |
| Fax Number: | 3074552526 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 20407 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |