DR. SAMUEL S WILBURN DNP AGNP NPI 1396355327

NPI Information

NPI: 1396355327
Provider Name: DR. SAMUEL S WILBURN, DNP, AGNP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Address:
1348 BAINBRIDGE ST
PHILADELPHIA, PA
ZIP 19147
Phone: (215) 563-0657
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DR. Samuel S Wilburn, DNP, AGNP is an adult health nurse practitioner in Philadelphia, PA. DR. Samuel S Wilburn, DNP, AGNP NPI is 1396355327. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1348 BAINBRIDGE ST
PHILADELPHIA, PA
ZIP 19147-810
Phone: (215) 563-0657

The enumeration date for this NPI number is 8/4/2020 and was last updated on 12/4/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	309784	NEW YORK	No
2	363LA2200X	Nurse Practitioner	Adult Health	SP022592	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SP022592	OTHER	PENNSYLVANIA	PENNSYLVANIA BOARD OF NURSING
2	309784	OTHER	NEW YORK	NEW YORK STATE DEPARTMENT OF EDUCATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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