Individual
JAMIE MICHELLE WHEELAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 B GALE WILSON BLVD, FAIRFIELD, CA 94533-3552
(707) 646-5300
(707) 646-5334
Mailing address
1200 B GALE WILSON BLVD, FAIRFIELD, CA 94533-3552
(707) 646-5300
(707) 646-5334
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
17220
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110636
LICENSE
NE
01
—
17220
LICENSE
CA
05
—
47037658373
—
NE
05
—
47078557542
—
NE
Enumeration date
05/01/2006
Last updated
06/14/2010
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