Shelly Rose Wilkes, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2014024802 Issued in MO

Practice address

3103 Parham Dr Apt 227
Grand Prairie, TX 75052-7726

Phone

(817) 495-4880

Fax

(214) 235-0789

NPI assigned

Oct 24, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445644800000",
    "number": "1043682453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 PARHAM DR APT 227",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527726",
            "telephone_number": "817-495-4880",
            "fax_number": "214-235-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 PARHAM DR APT 227",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527726",
            "telephone_number": "817-495-4880",
            "fax_number": "214-235-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "SHELLY",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-24",
        "last_updated": "2015-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2014024802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Whitham, DPT
• Ralph Thane Wiegman, MD
• Carlos Guillermo Wiesse, D.D.S.
• Brooke Wiggins
• Brianna Cheyenne Wilcox-Curley
• Graci Wilkins
• William Fan, OD PA
• William J. Luck
• Kimberlee Williams, RN
• Kimberly Williams

• Licensed Practical Nurse in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Licensed Practical Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.