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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. MIRIAM J WILBON, PA

Active Sole Proprietor

Medical Physician Assistant · ALEXANDRIA, LA

Registration Details

NPI Number
1629249347
Provider Type
Individual
Gender
Female
NPI Issued
Mar 20, 2008 (18.092270245283 yrs)
Last Updated
Feb 22, 2017
Licenses
G02542 (LA)
A10315 (LA)
A10315 (LA)
A10315 (LA)
Sole Proprietor
Yes

Practice Information

Address
3330 MASONIC DR
ALEXANDRIA, LA, 713013841
Browse LA providers · Browse ZIP 71301
Phone
3184871122
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Physician Assistant
Additional Specialty
Medical Physician Assistant
Additional Specialty
Surgical Physician Assistant

Other Medical Physician Assistant Providers in ALEXANDRIA, LA

Name Credential NPI
MS. KELLY G WHITE PA-C 1063415180
JAMIE DUNN PERROTTI PA 1174727986
MRS. AMY MICHELLE SUTER PA-C 1528237724
MRS. SARAH JEAN GRIFFIN P.A. 1396093837
LINDSAY TAYLOR VAUGHAN PA 1407689987
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.