Provider Demographics
NPI:1225011778
Name:WILHELM, PATRICE M (APRN)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:M
Last Name:WILHELM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:M
Other - Last Name:O'NEILL-WILHELM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:25 ARROWHEAD LN
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3905
Mailing Address - Country:US
Mailing Address - Phone:203-214-1242
Mailing Address - Fax:203-737-1077
Practice Address - Street 1:6 WOODLAND RD UNIT 3B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2685
Practice Address - Country:US
Practice Address - Phone:203-350-2030
Practice Address - Fax:478-202-9615
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002983363L00000X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004249159Medicaid
CT500001388Medicare ID - Type Unspecified
CT004249159Medicaid