Individual
DR. SAMUEL S WILBURN
Active
Individual
DR. SAMUEL S WILBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, AGNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
309784
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
SP022592
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309784
NEW YORK STATE DEPARTMENT OF EDUCATION
NY
01
—
SP022592
PENNSYLVANIA BOARD OF NURSING
PA
Enumeration date
08/04/2020
Last updated
12/04/2023
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