Provider Demographics
NPI:1770465247
Name:WILKE, AUDREY COLLARD (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:COLLARD
Last Name:WILKE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:COLLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 CAMARITAS CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-5437
Mailing Address - Country:US
Mailing Address - Phone:815-847-8113
Mailing Address - Fax:
Practice Address - Street 1:133 LA CASA VIA STE 140
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3005
Practice Address - Country:US
Practice Address - Phone:925-947-3322
Practice Address - Fax:925-451-3172
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035919363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner