Provider Demographics
NPI:1871227462
Name:WILHELM, KATHERINE LYNN (DNP, AG-ACNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:WILHELM
Suffix:
Gender:F
Credentials:DNP, AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SHIRLEY PL APT 206
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4135
Mailing Address - Country:US
Mailing Address - Phone:309-846-4728
Mailing Address - Fax:
Practice Address - Street 1:8900 BEVERLY BLVD FL 3
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-2438
Practice Address - Country:US
Practice Address - Phone:310-423-2641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019012363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care