Individual
MR. WAYNE FRANCIS WILBUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
57 PROSPECT ST, NANTUCKET, MA 02554-2799
(774) 563-1876
(401) 826-0410
Mailing address
57 PROSPECT ST, NANTUCKET, MA 02554-2799
(774) 563-1876
(401) 826-0410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
199070
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649359548
FALLON
—
01
—
NA1102
BCBS
MA
01
—
P00214045
RAILRAOD
—
Enumeration date
11/03/2006
Last updated
02/28/2010
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