Individual
ALYIS WILBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Mailing address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN305871
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN305871
BLUE CROSS BLUE SHIELD
OH
Enumeration date
08/19/2022
Last updated
08/19/2022
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