Wilderman, Lynnett M
Wilderman, Lynnett M is an individual health care provider with primary practice located at 2636 Eastern Ave , Plymouth WI 53073. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wilderman, Lynnett M can be contacted via phone (920) 893-4010.Contact Information
Primary practice address
2636 Eastern Ave
Plymouth WI 53073
Phone: (920) 893-4010
Fax: (920) 893-9402
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 933-023 | Wisconsin |
Profile Details
| NPI number | 1861509721 |
|---|---|
| LBN Legal business name | Wilderman, Lynnett M |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861509721 | NPPES |
| Wisconsin | MEDICAID | 42959600 |
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