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NPI Code Detail

MEDICARE: DANIEL WILBURN

MEDICARE: DANIEL WILBURN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0102482-C-NPCO

General Provider Information

NPI Number : 1083457402
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL WILBURN
Provider Business Mailing Address
First Line : 1040 NEWTON ST NE APT 1
Second Line :
City : WASHINGTON
State : DC
Zip : 20017-1713
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2121 I ST NW # 405
Second Line :
City : WASHINGTON
State : DC
Zip : 20052-0086
Country : US
Telephone Number : 202-908-8594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2024
Last Update Date : 06/13/2024

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Directions to “ DANIEL WILBURN ” Practice Location

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