Individual
DENISE WIBRAN SPONSELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
811 US 70 HWY W, GARNER, NC 27529-2541
(919) 235-6565
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04822
NC
363A00000X
Physician Assistant
MPA.2046
SC
Other
Enumeration date
01/27/2014
Last updated
04/13/2021
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