Provider Demographics
NPI:1407090376
Name:WILHELM, DONNA LEE (MSN/ARNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LEE
Last Name:WILHELM
Suffix:
Gender:F
Credentials:MSN/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 W COLLEGE ST STE 2200
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5326
Mailing Address - Country:US
Mailing Address - Phone:256-767-5864
Mailing Address - Fax:256-767-5862
Practice Address - Street 1:541 W COLLEGE ST STE 2200
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5326
Practice Address - Country:US
Practice Address - Phone:256-767-5864
Practice Address - Fax:256-767-5862
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2014-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP152363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00280106Medicare PIN
KYP00724311Medicare PIN