Provider Demographics
NPI:1073581195
Name:WILHELM, HANNAH K (PA-C)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:K
Last Name:WILHELM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 1450, NW 6035
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55485-1450
Mailing Address - Country:US
Mailing Address - Phone:952-542-8553
Mailing Address - Fax:952-513-6880
Practice Address - Street 1:5775 WAYZATA BOULEVARD
Practice Address - Street 2:SUITE 190
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2627
Practice Address - Country:US
Practice Address - Phone:952-541-1840
Practice Address - Fax:952-543-6524
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN9764363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN122800500Medicaid
MN122800500Medicaid