Provider Demographics
NPI:1497786388
Name:MECHSNER, WILMA KATHLEEN (NP)
Entity Type:Individual
Prefix:MS
First Name:WILMA
Middle Name:KATHLEEN
Last Name:MECHSNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:WILMA
Other - Middle Name:KATHLEEN
Other - Last Name:MECHSNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1288 MORRO ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6301
Mailing Address - Country:US
Mailing Address - Phone:805-543-1233
Mailing Address - Fax:805-547-1179
Practice Address - Street 1:1288 MORRO ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6301
Practice Address - Country:US
Practice Address - Phone:805-543-1233
Practice Address - Fax:805-547-1179
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR294484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily