Individual
MARCIA WILBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
14342 CRANBROOK CREEK LN, HOUSTON, TX 77044-6069
(832) 438-0797
Mailing address
14342 CRANBROOK CREEK LN, HOUSTON, TX 77044-6069
(832) 438-0797
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP141730
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
N/A
TX
Enumeration date
08/26/2019
Last updated
08/26/2019
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