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Individual
ABBY K WIBERG
Active
Individual
ABBY K WIBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R15678805
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R156788-5
LICENSE
MN
Enumeration date
09/27/2010
Last updated
10/22/2014
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