Provider Demographics
NPI:1417386871
Name:WILHELM, ANNELIESE KAY (APNP)
Entity Type:Individual
Prefix:
First Name:ANNELIESE
Middle Name:KAY
Last Name:WILHELM
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ANNELIESE
Other - Middle Name:KAY
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:230 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-3481
Mailing Address - Country:US
Mailing Address - Phone:608-668-2103
Mailing Address - Fax:
Practice Address - Street 1:230 PINE ST
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-3481
Practice Address - Country:US
Practice Address - Phone:608-668-2103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5565208D00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice