Doctor Name: | MRS. DEBRA ANN WILHELM |
NPI Number: | 1568511715 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 26NN07804900 |
Business Practice Address: | 6601 Ventnor Ave Troy Avenue St14 Ventnor City, NJ - 084062167 |
Business Phone Number: | 6094876507 |
Business Fax Number: | |
Mailing Address: | 6601 Ventnor Avenue, Troy Avenue St14 VENTNOR CITY |
State: | NJ |
Postal Code: | 08406 |
Phone Number: | 6094876507 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 12/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 26NN07804900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |