Individual
MARIE A WILBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10800 MIDLOTHIAN TPKE, SUITE 265, RICHMOND, VA 23235-4724
(804) 594-2622
(804) 594-0915
Mailing address
10800 MIDLOTHIAN TPKE, SUITE 265, RICHMOND, VA 23235-4724
(804) 594-2622
(804) 594-0915
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024135586
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008933944
—
VA
Enumeration date
06/22/2005
Last updated
07/23/2008
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