Individual
MS. NICOLE ANGELA WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9169 N JADAM LN, APT 204, MILWAUKEE, WI 53224-1872
(414) 241-7518
Mailing address
9169 N JADAM LN, APT 204, MILWAUKEE, WI 53224-1872
(414) 241-7518
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
302048-031
WI
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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