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NPI Code Detail

MEDICARE: ALICIA DANIELLE WILMETH FNP-BC

MEDICARE: ALICIA DANIELLE WILMETH FNP-BC
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
1363LF0000XFamily Nurse Practitioner1071478TX
2363LP2300XPrimary Care Nurse Practitioner1071478TX

General Provider Information

NPI Number : 1184370595
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA DANIELLE WILMETH FNP-BC
Provider Business Mailing Address
First Line : 4201 S LOOP 256
Second Line :
City : PALESTINE
State : TX
Zip : 75801-8476
Country : US
Telephone Number : 903-723-8533
Fax Number :
Provider Business Practice Location Address
First Line : 4201 S LOOP 256
Second Line :
City : PALESTINE
State : TX
Zip : 75801-8476
Country : US
Telephone Number : 903-723-8533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2022
Last Update Date : 02/24/2026

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Directions to “ ALICIA DANIELLE WILMETH FNP-BC” Practice Location

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