Healthcare Provider Details

I. General information

NPI: 1649105990
Provider Name (Legal Business Name): JAMIE MADISON WILBOURNE DNP FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL HEIGHTS DR
MORGANTON NC
28655-5197
US

IV. Provider business mailing address

119 W SPRAGUE ST
WINSTON SALEM NC
27127-2945
US

V. Phone/Fax

Practice location:
  • Phone: 828-433-4484
  • Fax:
Mailing address:
  • Phone: 980-808-6135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026055467
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: