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General NPI Number Information
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NPI Number | 1124167770
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Entity Type | Individual
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Provider Name | SHARALYN J WILBURN WHNP
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 114 GATEWAY CORPORATE BLVD SUITE 120
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City | COLUMBIA
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State | SC
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Zip | 29203
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Country | US
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Telephone | 803-865-4924
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Fax | 803-865-4925
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Provider Business Mailing Address
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Address Line | P.O. BOX 23321
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City | NEW YORK
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State | NY
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Zip | 10087
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Country | US
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Telephone | 803-936-7679
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | WH798
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN 798
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License Number State | SC
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