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General NPI Number Information
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NPI Number | 1386709681
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Entity Type | Individual
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Provider Name | DONNA JEAN WIBERG RN, NP
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Gender | Female
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 696 VIRGINIA RD
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City | CONCORD
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State | MA
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Zip | 01742-2718
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Country | US
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Telephone | 978-318-8952
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Fax | 978-318-9789
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Provider Business Mailing Address
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Address Line | 696 VIRGINIA RD
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City | CONCORD
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State | MA
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Zip | 01742-2718
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Country | US
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Telephone | 978-318-8952
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Fax | 978-318-9789
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 183905
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 183905
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License Number State | MA
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