Provider Demographics
NPI:1396346524
Name:WILHELMI, JOANNA LOUISE
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:LOUISE
Last Name:WILHELMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19312 LIGHTHOUSE PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-6158
Mailing Address - Country:US
Mailing Address - Phone:302-227-5954
Mailing Address - Fax:844-411-6344
Practice Address - Street 1:19312 LIGHTHOUSE PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-6158
Practice Address - Country:US
Practice Address - Phone:302-227-5954
Practice Address - Fax:844-411-6344
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0005239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist