Provider Demographics
NPI:1114935780
Name:WILHELM, SARA A (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:WILHELM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-4333
Mailing Address - Country:US
Mailing Address - Phone:785-273-8224
Mailing Address - Fax:
Practice Address - Street 1:4100 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-4333
Practice Address - Country:US
Practice Address - Phone:785-273-8224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0325245363A00000X
KS15-00871363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA2129015OtherMEDICARE PTAN
KS100424110BMedicaid
KS100424110AMedicaid
P66814Medicare UPIN