Wilburn, Denise Blair
Wilburn, Denise Blair is an individual health care provider with primary practice located at 1802 E 10Th St , Jeffersonville IN 47130-6016. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Allopathic & Osteopathic Physicians / Addiction Medicine. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Wilburn, Denise Blair can be contacted via phone (812) 288-2488.Contact Information
Primary practice address
1802 E 10Th St
Jeffersonville IN 47130-6016
Phone: (812) 288-2488
Fax: (770) 573-9513
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 3004516 | Kentucky |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4516P | Kentucky |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 71001728A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71001728A | Indiana |
Profile Details
| NPI number | 1417984758 |
|---|---|
| LBN Legal business name | Wilburn, Denise Blair |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Nov 8th, 2021 - about 5 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 | 1417984758 | NPPES |
| Indiana | Other | 71001728A | LICENSE NUMBER |
| Indiana | Other | 4526P | LICENSE NUMBER |
| Indiana | Other | 3004516 | LICENSE NUMBER |
| Indiana | Other | K156040 | LICENSE NUMBER |
| Indiana | Other | 1105450 | LICENSE NUMBER |
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