Provider Demographics
NPI:1023598414
Name:BLOCK-WILKINS, CAROLINE DORA (PMHNP-BC, CPNP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:DORA
Last Name:BLOCK-WILKINS
Suffix:
Gender:F
Credentials:PMHNP-BC, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 E MAYNARD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-2941
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5239 COLUMBUS RD STE A
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-9624
Practice Address - Country:US
Practice Address - Phone:614-924-7412
Practice Address - Fax:614-683-5850
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023019363LP0808X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No208000000XAllopathic & Osteopathic PhysiciansPediatrics