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NPI Code Detail

MEDICARE: MS. ROSIE ANN WILBON N. P.

MEDICARE: MS. ROSIE ANN WILBON N. P.
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 PractitionerR683205MS

General Provider Information

NPI Number : 1730148123
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSIE ANN WILBON N. P.
Provider Business Mailing Address
First Line : PO BOX 446
Second Line : 721 CEDAR CREEK ROAD
City : MACON
State : MS
Zip : 39341-0446
Country : US
Telephone Number : 662-726-5311
Fax Number :
Provider Business Practice Location Address
First Line : 606 N JEFFERSON ST
Second Line :
City : MACON
State : MS
Zip : 39341-2242
Country : US
Telephone Number : 662-726-4264
Fax Number : 662-726-4956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 01/28/2013

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