Provider Demographics
NPI:1750546388
Name:WILHELM, LORI ANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:WILHELM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1618
Mailing Address - Country:US
Mailing Address - Phone:914-835-3395
Mailing Address - Fax:914-835-3478
Practice Address - Street 1:623 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1618
Practice Address - Country:US
Practice Address - Phone:914-835-3395
Practice Address - Fax:914-835-3478
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251934-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse