Provider Demographics
NPI:1982639183
Name:WILHELM, MELANIE JILL (DNP CPNP-PC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:JILL
Last Name:WILHELM
Suffix:
Gender:F
Credentials:DNP CPNP-PC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:JILL
Other - Last Name:FROST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:601 CHILDRENS LN STE 200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-461-6342
Mailing Address - Fax:
Practice Address - Street 1:612 KINGSBOROUGH SQ STE 301
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5055
Practice Address - Country:US
Practice Address - Phone:757-436-1770
Practice Address - Fax:757-436-4303
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017137517363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
10007206OtherOPTIMA INSURANCE
VA010261520Medicaid