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General NPI Number Information
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NPI Number | 1124373121
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Entity Type | Individual
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Provider Name | DARLENE MARIE WILHELM CNP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | 2702 NAVARRE AVE STE 320
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City | OREGON
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State | OH
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Zip | 43616-3224
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Country | US
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Telephone | 419-696-5555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone | 505-923-6770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 13526NP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.13526
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License Number State | OH
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