Wilbon, Miriam J
Wilbon, Miriam J is an sole proprietor health care provider with primary practice located at 3330 Masonic Dr , Alexandria LA 71301-3841. She recently has 4 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Medical Technologist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Wilbon, Miriam J can be contacted via phone (318) 487-1122.Contact Information
Primary practice address
3330 Masonic Dr
Alexandria LA 71301-3841
Phone: (318) 487-1122
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Technologists, Technicians & Other Technical Service Providers / Medical Technologist | 246QM0706X | G02542 | Louisiana |
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | A10315 | Louisiana |
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | A10315 | Louisiana |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | A10315 | Louisiana |
Profile Details
NPI number | 1629249347 |
---|---|
LBN Legal business name | Wilbon, Miriam J |
Credentials | Physician Assistant (PA) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 20th, 2008 |
Last updated | Feb 22nd, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629249347 | NPPES |
Louisiana | MEDICAID | 1886203 |
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