Individual
MS. MARY LYNN WILBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP
Contact information
Practice address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104-4206
(215) 615-5858
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4204
(215) 615-5858
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
VP004387C
PA
Other
Enumeration date
03/14/2008
Last updated
11/28/2011
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