Provider Demographics
NPI:1134389877
Name:WILMER, CHERYL (RNFA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:WILMER
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7812 SPOUT SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2834
Mailing Address - Country:US
Mailing Address - Phone:301-788-2284
Mailing Address - Fax:240-668-5612
Practice Address - Street 1:7812 SPOUT SPRING RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-2834
Practice Address - Country:US
Practice Address - Phone:301-788-2284
Practice Address - Fax:240-668-5612
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR131806163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant