Provider Demographics
NPI:1134471113
Name:WILDHARBER, CARI B (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:B
Last Name:WILDHARBER
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:CARI
Other - Middle Name:B
Other - Last Name:DARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, NP-C
Mailing Address - Street 1:2200 JEFFERSON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7102
Mailing Address - Country:US
Mailing Address - Phone:419-251-2032
Mailing Address - Fax:
Practice Address - Street 1:6321 KENTUCKY DAM RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-9471
Practice Address - Country:US
Practice Address - Phone:270-898-2444
Practice Address - Fax:270-898-4753
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100221440Medicaid
KYK064710Medicare PIN