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Individual
CHRISTINE A WILZACK
Active
Individual
CHRISTINE A WILZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMH-CNS, FNP, PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R104565
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5006513
NC
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
R104565
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356303796
—
MD
Enumeration date
04/03/2006
Last updated
02/06/2026
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