Provider Demographics
NPI:1689453417
Name:WILHELMI, JENA RAE
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:RAE
Last Name:WILHELMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:R
Other - Last Name:VOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7210
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:1976 LIME KILN RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4417
Practice Address - Country:US
Practice Address - Phone:920-445-7377
Practice Address - Fax:920-592-9479
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13736-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily