| Doctor Name: | JENNA WILKENS |
| NPI Number: | 1336543297 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 018028 |
| Business Practice Address: | 220 Steuben St Montour Falls, NY - 148659740 |
| Business Phone Number: | 6075357154 |
| Business Fax Number: | |
| Mailing Address: | 4085 Ball Diamond Rd, HECTOR |
| State: | NY |
| Postal Code: | 148419630 |
| Phone Number: | 6072156637 |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2014 |
| NPI Last Update Date: | 10/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 018028 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |