Individual
MS. ELIZABETH COURTNEY WILHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4740 NW 39TH PL STE C, GAINESVILLE, FL 32606-7226
(352) 265-5240
Mailing address
PO BOX 100225, GAINESVILLE, FL 32610-0225
(352) 273-8737
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103861
FL
363AM0700X
Medical Physician Assistant
PA9103861
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292547800
—
FL
01
—
AB679Y
MEDICARE PTAN
FL
Enumeration date
09/21/2006
Last updated
11/02/2021
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