Provider Demographics
NPI:1851026686
Name:WILHELM, NINA THERESE (PA-C)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:THERESE
Last Name:WILHELM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 LANARK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8697
Mailing Address - Country:US
Mailing Address - Phone:848-658-5437
Mailing Address - Fax:833-820-1010
Practice Address - Street 1:5425 LANARK RD STE 101
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8697
Practice Address - Country:US
Practice Address - Phone:484-658-5437
Practice Address - Fax:833-820-1010
Is Sole Proprietor?:No
Enumeration Date:2022-07-17
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
PAMA065262363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant