Doctor Name: | SANDRA KAY WILBANKS |
NPI Number: | 1356340103 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 4704130169 |
Business Practice Address: | 7362 Midland Rd Freeland, MI - 486238803 |
Business Phone Number: | 9896927000 |
Business Fax Number: | 9896952757 |
Mailing Address: | 1447 N Harrison St, SAGINAW |
State: | MI |
Postal Code: | 486024727 |
Phone Number: | 9896927000 |
Fax Number: | 9896952757 |
NPI Enumeration Date: | 07/14/2005 |
NPI Last Update Date: | 06/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704130169 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |