Provider Demographics
NPI:1265515720
Name:DILKS, WILLIAM C (CRNP)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:DILKS
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 VALLEY FORGE ROAD
Mailing Address - Street 2:SUITE 64, BOX 604
Mailing Address - City:VALLEY FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:19482
Mailing Address - Country:US
Mailing Address - Phone:610-935-5600
Mailing Address - Fax:610-935-0830
Practice Address - Street 1:1288 VALLEY FORGE ROAD
Practice Address - Street 2:SUITE 64, BOX 604
Practice Address - City:VALLEY FORGE
Practice Address - State:PA
Practice Address - Zip Code:19482
Practice Address - Country:US
Practice Address - Phone:610-935-5600
Practice Address - Fax:610-935-0830
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006784C363LA2200X
PASP008419363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ14255Medicare UPIN
PA078400JDEMedicare ID - Type Unspecified