MEDICARE: CHERYL WILMER RNFA

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
1	163WR0006X	Registered Nurse First Assistant	R131806	MD

General Provider Information

NPI Number	:	1134389877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL WILMER RNFA

Provider Business Mailing Address
First Line	:	7812 SPOUT SPRING RD
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-2834
Country	:	US
Telephone Number	:	301-788-2284
Fax Number	:	240-668-5612

Provider Business Practice Location Address
First Line	:	7812 SPOUT SPRING RD
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-2834
Country	:	US
Telephone Number	:	301-788-2284
Fax Number	:	240-668-5612

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	03/13/2012

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