Provider Demographics
NPI:1134742034
Name:WILHELM, ELIZABETH (DNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WILHELM
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 LANDMARK DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6524
Mailing Address - Country:US
Mailing Address - Phone:919-788-4203
Mailing Address - Fax:
Practice Address - Street 1:2411 LANDMARK DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6524
Practice Address - Country:US
Practice Address - Phone:919-788-4203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCWILH-5KJ9N363LF0000X
390200000X
NC5015065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program