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NPI Code Detail

MEDICARE: MRS. ILENE WALLMUELLER ARNP

MEDICARE: MRS. ILENE WALLMUELLER ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP748022FL
2363L00000XNurse PractitionerAPN.0993189-NPCO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922000827
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ILENE WALLMUELLER ARNP
Provider Business Mailing Address
First Line : 2312 N NEVADA AVE STE 235
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-5312
Country : US
Telephone Number : 719-571-8840
Fax Number : 719-571-8845
Provider Business Practice Location Address
First Line : 2312 N NEVADA AVE STE 235
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-5312
Country : US
Telephone Number : 719-571-8840
Fax Number : 719-571-8845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 11/20/2017

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