Provider Demographics
NPI:1013066877
Name:WILHELM, CHARLA GAY (RN)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:GAY
Last Name:WILHELM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MEDICAL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3114
Mailing Address - Country:US
Mailing Address - Phone:361-575-0681
Mailing Address - Fax:361-575-0100
Practice Address - Street 1:117 MEDICAL DR STE 4
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3114
Practice Address - Country:US
Practice Address - Phone:361-575-0681
Practice Address - Fax:361-575-0100
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX585061163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management