Individual
PANSY A WILBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
904 S STRONG DR, GALLUP, NM 87301-5965
(480) 878-9031
Mailing address
5500 HIGHWAY 282, RUDY, AR 72952-9058
(479) 420-4431
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
R091737
AR
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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